Tricuspid Valve Atresia (TVA) refers to a congenital heart condition that is characterized by the complete lack of a tricuspid valve. This lack of communication between the right heart chambers results in a hypo plastic right ventricle.
Other associated features include:
- Patent foramen ovale/atrial septal defect
- Ventricular septal defect
- Pulmonary stenosis (from decreased blood flow out of the pulmonary valve)
WHY IS THIS A PROBLEM?
Because the tricuspid valve is absent NO BLOOD WILL TRAVEL DIRECTLY FROM THE RIGHT ATRIUM TO THE RIGHT VENTRICLE. As a result, less blood will be pumped out to the lungs.
WHAT MAKES US SUSPECT IT?
- Cyanosis in newborns
- Holosystolic murmur can be caused by ventral/septal defect
Chest X-Ray: while not a diagnostic study, a chest radiograph can reveal the following features of TVA:
- Decreased pulmonary markings: this is due to the lack of blood flow to the lungs.
Electrocardiogram: the cardiac changes seen in TVA can be reflected on a EKG study (in newborns):
- Left axis deviation: typically newborn should have right axis deviation given that blood is shunted away from the left side of the fetal heart (and the right side is larger in newborns)
- Small/absent R waves in precordial leads: similar reasons as to why left axis deviation is seen in TVA.
- Tall/peaked P waves: the atrial spatial defect permits increased blood flow to the right atrium which causes its enlargement (in turn causing this EKG finding).
HOW DO WE TREAT IT?
ARCHIVE OF STANDARDIZED EXAM QUESTIONS
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Page Updated: 11.23.2016