Clinical Features

Valvular Disorders of the Heart Right-sided Valve Lesions Clinical Features

Patients are usually asymptomatic unless right heart failure develops and the patient complains of oedema, ascites and abdominal pain from liver congestion. Intravenous drug abusers may present acutely unwell with a staphylococcal endocarditis.
What are the clinical, ECG and CXR findings associated with TR?

Table 1: The clinical, ECG and CXR findings associated with TR
Pulse	AF common large C-V waves in JVP
Auscultation	Soft pansystolic murmur at LSE louder on inspiration Third heart sound (S3) often heard
ECG	No specific changes
CXR	Cardiomegaly, pleural effusion
Other features	Tender enlarged pulsatile liver

How would you treat tricuspid endocarditis in a drug abuser?

A drug abuser needs blood cultures and aggressive antibiotic therapy covering staphylococcal infection. Early surgery may be needed.

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