Competence of the Tricuspid Valve in Pulmonary Heart Disease (Cor Pulmonale)

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Abstract
Seventy right atrial curves obtained by cardiac catheterization of patients with cor pulmonale were reviewed. Only one right atrial tracing showed a regurgitant pressure wave, despite a wide distribution of right atrial mean, right ventricular end-diastolic, and pulmonary artery mean pressures, systemic blood flow, and despite the presence of peripheral venous congestion at the time of study in 46% of the cases. This tricuspid regurgitation was probably due to the hemodynamic consequence of a prolonged P-R interval, an unusual finding in cor pulmonale. It was concluded that uncomplicated cor pulmonale rarely produced tricuspid regurgitation, as judged by the right atrial pressure curve. The clinical signs often attributed to tricuspid regurgitation when noted in the presence of right ventricular failure are probably explained by the sudden reversal of flow from atrium to veins, consequent to the large pressure variations originating in a congested right atrium.