Tricuspid and Pulmonic Valve

The focus of this chapter is the anatomy & pathology of the tricuspid and pulmonic valves. This subject matter holds relevance to the intensive care provider as accurate evaluation of both valves can help guide clinical decision making and understand the patient’s cardiodynamic physiology. Echocardiography can help identify pathologies such as infective endocarditis, rheumatic heart disease, tricuspid valve stenosis, tricuspid valve regurgitation, pulmonic valve stenosis & regurgitation, right heart chamber dilatation, inferior vena cava and portal vein flow reversal and other relevant findings. Knowledge and ability to identify and grade the severity of tricuspid and pulmonic valve regurgitation and/or stenosis can guide patient’s management and predict possible harmful effects of certain interventions such as intravenous fluid bolus or excessive end expiratory positive pressure. In addition, Doppler based interrogations can also help estimate right ventricular systolic pressure, pulmonary artery pressures and right atrial pressures among other measurements. This requires knowledge of image acquisition, Doppler physics as pertinent to the tricuspid & pulmonic valves, normal valve anatomy, physiology and specific patterns of disease as seen on 2D echocardiography and Doppler which will be covered in this chapter.