Tricuspid valve prolapse diagnosed by cross-sectional echocardiography.

Cross-sectional echocardiography utilizing the apical and longitudinal right ventricular inflow tract views was used to investigate the tricuspid valve in 64 patients with mitral valve prolapse and 16 controls who had no angiographic or echocardiographic evidence of mitral valve prolapse. The tricuspid valve leaflets and their coaptation point in systole were found to be below (towards the right ventricular apex) the level of the tricuspid valve ring in systole in all controls. Tricuspid valve prolapse, defined as the leaflet(s) of the tricuspid valve lying above the tricuspid valve ring level within the right atrium, was seen in 31/64(48 percent) of patients with mitral valve prolapse. The right ventricular inflow tract view demonstrated tricuspid valve prolapse most readily compared to the apical view, and 29 of the 31 patients with tricuspid valve prolapse had prolapse of at least two leaflets of the tricuspid valve. The 31 patients with both mitral and tricuspid valve prolapse, when compared to the 33 patients with mitral valve prolapse alone, had more symptomatology and abnormal physical findings.