Massive tricuspid regurgitation identified on renal flow scintigraphy.

A Tc-99m glucoheptonate renal flow study performed in a patient with chronic renal insufficiency and worsening congestive heart failure demonstrated evidence of massive tricuspid regurgitation, with activity appearing in a markedly dilated inferior vena cava within 4 seconds of the tracer bolus entering the right ventricle. Autopsy subsequently confirmed the scintigraphic findings, demonstrating an incompetent tricuspid valve secondary to immobilization of the posterior leaflet as a result of adhesions from a longstanding right ventricular pacemaker wire.