Tricuspid stenosis masquerading as right ventricular failure in a patient with a prosthetic mitral valve

Echocardiographic, phonocardiographic, and pulse tracing recordings demonstrated clinically unsuspected tricuspid stenosis in a 53-year-old man with a prosthetic mitral valve and signs of right heart failure. Physiologic correlates of the patient's heart sounds and diastolic murmur were studied by simultaneous M-mode echocardiograms and phonocardiograms. Cardiac catheterization and subsequent valve surgery confirmed the presence of tricuspid stenosis. It is important to consider the diagnosis of tricuspid stenosis in all patients with a history of rheumatic mitral valve disease who develop findings suggestive of right ventricular failure.