Tricuspid Stenosis

Tricuspid stenosis is a diastolic murmur similar in quality to mitral stenosis, but is best heard over the left lower sternal border, or between the left lower sternal border and the apex. It also becomes louder with inspiration (Carvallo’s sign).
Associated findings include a giant a wave in the jugular venous waveform (accentuated with inspiration), as well as a diminished y descent.

Patient 2

This is a young woman with a history of intravenous drug use complicated by infective endocarditis of the tricuspid valve which was replaced with a bioprosthesis. Physical examination was consistent with tricuspid stenosis. Echocardiography revealed normal valve function with an elevated peak gradient of 7 mm Hg.

Tricuspid Stenosis

Annotated