A Handbook of Tricuspid and Pulmonary Valve Disease
By Alok Ranjan
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A Handbook of Tricuspid and Pulmonary Valve Disease - Alok Ranjan
A Handbook Of Tricuspid and Pulmonary Valve Disease
Alok Ranjan
MD, DNB, MRCP (UK), DM (Card.)
Sr. Consultant - Cardiology
Wockhardt Hospitals
India
US%26UKLogoB%26Wnew.aiAuthorHouse™
1663 Liberty Drive
Bloomington, IN 47403
www.authorhouse.com
Phone: 1-800-839-8640
© 2012 Dr. Alok Ranjan. All rights reserved.
No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.
Published by AuthorHouse 12/11/2012
ISBN: 978-1-4772-9057-6 (sc)
ISBN: 978-1-4772-9056-9 (hc)
ISBN: 978-1-4772-9055-2 (e)
Library of Congress Control Number: 2012921604
Any people depicted in stock imagery provided by Thinkstock are models,
and such images are being used for illustrative purposes only.
Certain stock imagery © Thinkstock.
Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.
Contents
Disclaimer
The Tricuspid Valve Complex
Tricuspid Stenosis (TS)
Etiology
Hemodynamics
Clinical features
Investigations
Management
Tricuspid Regurgitation (TR)
Etiology
Clinical Features
Investigations
Management
Ebstein’s Anomaly of Tricuspid Valve
Background
Pathophysiology
Clinical features of Ebstein’s anomaly
Natural History
Management
Pulmonary Valve
Pulmonary Stenosis (PS)
Etiology
Clinical Features
Investigations
Management
Pulmonary Regurgitation (PR)
Etiology
Clinical Features
Investigations
Management
Straight Back Syndrome
Suggested Reading
Abbreviations
About the Author
Disclaimer
Medicine is a constantly changing science. New research findings necessitate continual changes in disease concept and its management. The author and publisher of this handbook have used reasonable efforts to provide up-to-date, accurate information that is within generally accepted medical standards at the time of publication. However, as medical science is ever evolving, and human error is always possible, the author and publisher (or any other involved parties) do not guarantee total accuracy or comprehensiveness of the information in this handbook, and they are not responsible for omissions, errors, or the results of using this information. The reader should confirm the accuracy of the information in this handbook from other sources. In particular, all drug doses, indications, and contraindications should be confirmed in package inserts.
The author has made every effort to trace the copyright holders for borrowed material. If he has inadvertently overlooked any, he will be pleased to make necessary arrangement at the first opportunity.
Dedicated to my teachers and friends in premedical school and colleges
Those who educate children well are more to be honored
than parents, for these only gave life,
those the art of living well.
‘Aristotle’
The Tricuspid Valve Complex
The tricuspid valve complex consists of three leaflets, the chordae tendinae, two discrete papillary muscles, the fibrous tricuspid annulus, and the right atrial and right ventricular myocardium.
Leaflets: There are three sail-like leaflets: anterior, posterior, and septal. All are attached to the tricuspid valve annulus. The anterior leaflet is the largest and is the most anatomically constant of the three, whereas the posterior leaflet is notable for the presence of multiple scallops. The septal leaflet is the smallest and arises medially directly from the tricuspid annulus above the interventricular septum. Because the small septal wall leaflet is fairly fixed, there is little room for movement if the free wall of right ventricular/tricuspid annulus should dilate. Dilation of the tricuspid annulus therefore occurs primarily in its anterior/posterior (mural) aspect, which can result in significant functional TR as a result