Value of two-dimensional echocardiography in detecting tricuspid stenosis

We reviewed the M-mode and two-dimensional echocardiograms of 100 consecutive patients with rheumatic heart disease. All were subsequently studied by cardiac catheterization and angiography. In four patients, cardiac catheterization showed tricuspid stenosis (average mean diastolic gradient 6.2 mm Hg), which was confirmed during cardiac surgery. M-mode echocardiography showed a diminished EF slope in 12 patients (mean 26 mm/sec), including the four patients with tricuspid stenosis. Seven of the eight patients without tricuspid stenosis had significant pulmonary hypertension; the reasons for the diminished EF slope in the other patient could not be identified. Tricuspid stenosis was diagnosed in four patients from two-dimensional echocardiograms on the basis of diastolic doming and restricted leaflet motion of the tricuspid valve. These four patients were the same patients in whom tricuspid stenosis was diagnosed by cardiac catheterization. We conclude that two-dimensional echocardiography is useful in the diagnosis of tricuspid stenosis.