Tricuspid insufficiency/tricuspid regurgitation is a disorder involving backward flow of blood across the tricuspid valve, which separates the right ventricle (lower heart chamber) from the right atrium (upper heart chamber). This occurs during contraction of the right ventricle and is caused by damage to the tricuspid heart valve or enlargement of the right ventricle.

Risk Factors

The most common cause of tricuspid regurgitation is not damage to the valve itself, but enlargement of the right ventricle, which may be a complication of any disorder that causes failure of the right ventricle.

Rheumatic fever, diet medications such as Phen-fen (phentermine and fenfluramine) or dexfenfluramine, and a congenital heart disease (Ebstein anomaly) are also risk factors for tricuspid regurgitation.

Rarely, tricuspid regurgitation is caused by an unusual tumor called carcinoid, which secretes a hormone that damages the valve. Other infrequent causes of tricuspid regurgitation include endocarditis, rheumatoid arthritis, radiation therapy, Marfan syndrome, and injury.


In the absence of high blood pressure in the lungs (pulmonary hypertension), tricuspid regurgitation is usually asymptomatic. If pulmonary hypertension and moderate-to-severe tricuspid regurgitation coexist, symptoms may include:

  • Active neck vein pulsations
  • Decreased urine output
  • Fatigue, tiredness
  • Generalized swelling
  • Swelling of the abdomen
  • Swelling of the feet and ankles
  • Weakness

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