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 5

This is a 60 y/o female with a history of congenital heart disease with sinus venosus ASD of SVC status-post remote surgical correction c/b severe tricuspid regurgitation s/p bioprosthetic tricuspid valve replacement 7 years prior, who presents with progressive dyspnea, and is found to have severe stenosis of the bioprosthetic tricuspid valve.