[Doppler-ultrasonic diagnosis of tricuspid insufficiency]

The positive diagnosis of tricuspid insufficiency is simple: it consists in demonstrating in pulsated Doppler, the presence of retro-tricuspid systolic turbulence in the right atrium. The best views for this diagnosis are the 4 cavities apical section and the mitro-tricuspid section. This criterion appears to be extremely specific and only exceptional left ventricle-right atrium communications are capable to also generate right intra-atrial turbulences. In our experiment the sensitivity is close to 93%. The advantage of the continuous Doppler is to permit the measurement of the maximal velocity of the regurgitating tricuspid flow and the evaluation of the right ventricular pressure and the pulmonary artery pressure. The best criteria of gravity of tricuspid insufficiency are: the acoustical and graphic intensity of the Doppler signal, the spatial extension of systolic turbulences within the right atrium, the velocity of the anterograde tricuspid flow which reaches and exceeds lm/sec in severe tricuspid insufficiencies, and the laminar nature of the regurgitating flow, a sign of great value in favor of a massive tricuspid insufficiency. The color Doppler represents the future.