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. 2020 Oct 13;115(4):720–775. [Article in Portuguese] doi: 10.36660/abc.20201047

Table 43. Step 2: Evaluation of severe tricuspid regurgitation etiology150.

Etiological characteristics
Primary

  • Rheumatic fever

  • Prolapse and myxomatous degeneration

  • Actinic injury due to radiation (post-radiotherapy)

  • Closed chest trauma

  • Infective endocarditis

  • Repeated endomyocardial biopsies

  • Carcinoid syndrome

  • Congenital (Ebstein)

  • Pacemaker electrodes or defibrillator
Secondary

  • Dilation of the tricuspid annulus (> 40 mm or > 21 mm/m²)

  • Left heart valve disease

  • Long-duration AF

  • Primary PH

  • Right ventricular cardiomyopathy (ischemic, arrhythmogenic dysplasia, non-compacted myocardium, hypertrophic cardiomyopathy)

    Constrictive pericarditis
Rare causes

  • Rheumatologic diseases

  • Medication (methysergide or anorexigenic drugs)

  • Fabry disease

AF: atrial fibrillation; PH: pulmonary hypertension.