Detection of tricuspid regurgitation with two-dimensional echocardiography and peripheral vein injections

"Contrast echocardiography", utilizing a two-dimensional ultrasound system and peripheral venous injections, was used for the detection of tricuspid regurgitation in 30 patients. The appearance of contrast in the inferior vena cava and the back and forth movement of contrast across the tricuspid valve were considered evidence for tricuspid regurgitation. Echocardiographic findings were correlated with clinical and angiographic data. Patients were assigned on the basis of clinical data to one of three groups. Group I included five patients whose clinical findings were diagnostic for tricuspid regurgitation. Group II included patients (15) whose clinical findings were equivocal for tricuspid regurgitation and patients whose recognized primary problem is frequently associated with tricuspid regurgitation. Group III contained ten patients serving as controls. All group I patients had positive echocardiographic studies for tricuspid regurgitation, while all group III patients had negative studies, suggesting that this technique may be specific for tricuspid regurgitation. Among the group II patients were three who had positive echocardiographic studies despite the absence of specific clinical findings of tricuspid regurgitation, suggesting that this technique may be more sensitive than the methods in common use.