Tricuspid insufficiency



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Note that the intensity of the murmur increases with inspiration (Carvallo's sign)

Most commonly, tricuspid regurgitation (TR) is functional and due to marked dilatation of the tricuspid annulus. A variety of acquired and congenital heart diseases may eventuate in TR.

A "blowing" holosystolic murmur which increases with inspiration (Carvallo's sign) is characteristic. Signs of right ventricular enlargement (a parasternal tap or thrust and retrosternal dullness) and right-sided congestive heart failure may be present. A large right atrium may enlarge the heart to the right on percussion.

Retrograde flow of blood into the superior and inferior vena cava can cause accentuation of jugular c and v waves, and systolic pulsations of the liver.