Tricuspid Insufficiency


Categories: Uncategorized
Sources: Disturbances Of The Heart

This rarely, if ever, occurs alone; it is generally a sequence of

other valvular defects, and represents an overworked, dilated right

ventricle. It may, however, occur from lesions of the lungs which

impede the blood flow through them. Such are fibroid changes in the

lungs, emphysema, prolonged chronic bronchitis, the last stages of

pulmonary tuberculosis, old neglected pleurisies with cirrhosis or

fibrosis of the lung, and repeated attacks of asthma--anything,

whether valvular defect or pulmonary circulatory disturbance, which

increases the pressure ahead and the work of this ventricle.



The symptoms are those of loss of compensation as described under

other valvular lesions. There may be jugular pulsation, especially

evident in the external jugular on the left side. The liver enlarges

and may pulsate. There are edemas, dropsies, ascites and perhaps

hemorrhages. The heart is enlarged and there is a soft systolic blow

heard at the lower end of the sternum. The dyspnea is sometimes very

great, and cyanosis may be present, especially during paroxysms of

coughing.



This lesion of the heart is always benefited by digitalis, but the

continuance of the improvement and its amount depend, of course, on

the cause of the dilatation of the ventricle. Strychnin is often of

advantage. These patients should rarely receive vasodilators, and

hot baths, overheating, overloading the stomach and vigorous purging

should never be allowed. Sometimes improvement will not take place

until ascitic or pleuritic fluid, if present, has been removed.





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