Table 1

Etiologies of TR

Morphological ClassificationDisease SubgroupSpecific Abnormality
Primary leaflet abnormality: 25%CongenitalEbstein’s anomaly
Tricuspid valve tethering associated with perimembranous VSD and VSA
Other (giant right atrium)
Acquired diseaseCarcinoid
Degenerative (myxomatous)
Endocarditis
Endomyocardial fibrosis
Iatrogenic (pacing leads, RV biopsy)
Rheumatic
Toxins
Trauma
Other (e.g., ischemic papillary muscle rupture)
Secondary (“functional”): 75%Left heart diseaseLV dysfunction or valve disease
Right ventricular dysfunctionRV cardiomyopathy (e.g., ARVD)
RV ischemia
RV volume overload
Pulmonary HypertensionChronic lung disease
Left-to-right shunt
Pulmonary thromboembolism
Right atrial abnormalitiesAtrial fibrillation
OtherPost-operativeRecurrent TR post-surgical intervention

ARVD = arrhythmogenic right ventricular dysplasia; LV = left ventricle; RV = right ventricle; TR = tricuspid regurgitation; VSA = ventricular septal aneurysm; VSD = ventricular septal defect.