Re: Is the tricuspid valve ever associated with a heart mumur?

Let's go to basics: Blood arrives in the atrium, and moves into the ventricule during systole (i.e. atrial contraction). This motion is silent, provided that the valve is "normal". Normality implies that the components of the valve (the leaflets) move freely, and do not have a reverse motion during ventricular pressure increase (systole). In case of valvular abnormality (i.e. stenosis, prolapse), blood flow moves from "laminar" to "turbulent" state. Practically speaking, blood moves linearly through the valve during laminar flow, and produces no murmur or other abnormal sound. On the other hand, turbulent flow (whirlpools occur) creates murmurs that are audible with a stethoscope. The triscupisd valve is different from the mitral valve (wich is located betwwen left atrium and left ventricule). There is a very different pressure regimen through these valves. The gradient is something like 15 mm Hg through the triscupid valve, while the gradient is physiologically as high as 90 or 100 mm Hg through the mitral vale. This explains that you hear (rather easily) a murmur caused by MITRAL valve prolapse, while it's nearly impossible to hear the murmur caused by TRICUSPID valve prolapse. Tricuspid valve abnormamities are caused by congenital abnormalities during infancy and childhood, and mainly by staphylococcal infections among teen-agers and adults. When a tricuspid valve disease is suspected, the patient will undergo cardiac echography. Pictures will display leaflets abnormalities and, more sensitive, Doppler flow measurement will highlight reverse flow (from right ventricule to right atrium) during systole. Hope this helps Luc Luc Ronchi, MD Ped Anesthesia Hopital de Saint Nazaire (France)