Pathophysiology

The Big Heart Disease Lie

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Right-sided valvular heart disease is much less common than left-sided valvular disease. Drug users with endocarditis due to aggressive organisms, such as Staphylococcus aureus, are the largest group of patients with isolated tricuspid disease. Right ventricular failure with dilation may lead to tricuspid incompetence. Rheumatic heart disease may affect more than one valve, and tricuspid disease is frequently seen in conjunction with left-sided valvular disease. Rarely, blunt trauma can lead to tricuspid incompetence.

Pulmonary incompetence is most commonly due to pulmonary hypertension, and symptoms of pulmonary hypertension dominate the clinical picture. The most common cause of pulmonary stenosis is congenital tetralogy of Fallot, which is usually corrected surgically in infancy.

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