to hear murmur
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
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.