-Rheumatic in origin, more common in female than in male. Severe TS who have mean diastolic pressure gradients exceeding ~4 mmHg and tricuspid orifice areas <1.5–2.0 cm²
-Pathophysiology: Elevation of the RA pressure=> RA enlargement + systemic venous congestion.
-Symptom: symptoms of systemic venous congestion are congestive hepatomegaly (cirrhosis, jaundice, serious malnutrition, anasarca, and ascites, presystolic pulsations of the enlarged liver) + the jugular veins(+). The diastolic murmur of TS is generally heard best along the left lower sternal margin and over the xiphoid process, and it is most prominent during presystole in patients with sinus rhythm. The murmur of TS is augmented during inspiration, and it is reduced during expiration and particularly during the strain phase of the Valsalva maneuver, when tricuspid blood flow is reduced.
-Treatment: salt restriction, bed rest, and diuretic therapy. A preparatory period may diminish hepatic congestion and thereby improve hepatic function that avoids the risk of bleeding in operation. The tricuspid valve may have to be replaced with a prosthesis.