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.

Card Tutorial

Patient 4

This is a young man with tricuspid valve replacement complicated by tricuspid valve stenosis. Note the diastolic murmur that accentuates just before S1.