TRblåsljuden

TRblåsluden refers to the heart murmur associated with tricuspid regurgitation (TR), the backflow of blood from the right ventricle into the right atrium during systole due to imperfect tricuspid valve closure. It is typically a holosystolic, high-pitched blowing murmur best heard along the left lower sternal border, and its intensity often increases with inspiration (Carvallo sign). The murmur may radiate along the left sternal border and varies with body position and preload.

Causes include primary TR, where the valve itself is diseased (rheumatic involvement, infective endocarditis, Ebstein anomaly, carcinoid syndrome), and secondary or functional TR, resulting from annular dilation and right ventricular enlargement due to pulmonary hypertension, left-sided heart disease, or advanced age. Many TR cases are mild and asymptomatic; significant symptoms may arise from right-sided heart failure.

Diagnosis relies on imaging, with echocardiography as the cornerstone. Transthoracic or, if needed, transesophageal echocardiography assesses the severity of regurgitation, right atrial and ventricular size, tricuspid annulus diameter, and right-sided function. Doppler measurements quantify regurgitant flow. ECG and chest imaging support assessment of related cardiac conditions.

Management focuses on the underlying cause and symptom relief. Diuretics aid congestion; treatment may target associated conditions such as pulmonary hypertension or left-sided heart disease. Severe or progressive TR with symptoms or RV dysfunction may require surgical repair or replacement of the tricuspid valve, often in the context of other cardiac surgery. In selected cases, percutaneous approaches are considered. Prognosis depends on etiology, severity, and right ventricular function.