A leaky tricuspid valve may make you feel tired or make it difficult to exercise. Learn how this type of heart valve disease is diagnosed and treated.
Update Date: 23.09.2026
Tricuspid valve regurgitation is a type of heart valve disease. The valve between the two right heart chambers doesn't close as it should. This causes blood to flow backward through the valve. Blood moves from the lower right heart chamber, called the right ventricle, into the upper right chamber, called the right atrium. It may be described as a leaky tricuspid valve and is one type of tricuspid valve disease. The condition also may be called tricuspid regurgitation or tricuspid insufficiency.
If the valve leak is severe, forward blood flow may decrease and pressure may rise in the right atrium and veins.
Some people are born with heart valve disease that leads to tricuspid valve regurgitation. This is called congenital heart valve disease. But tricuspid valve regurgitation also may happen later in life due to infections, pacemaker implantation issues or other health conditions.
Mild and even moderate tricuspid valve regurgitation may not cause symptoms or need treatment. If the condition is severe and causes symptoms, medicine or a procedure to repair or replace the valve may be needed.
The main types of tricuspid valve regurgitation are primary, secondary and device related. Primary regurgitation mainly affects the tricuspid valve's leaflets or supporting structures. Secondary regurgitation happens when changes to the right atrium, right ventricle or ring around the valve keep the tricuspid valve from closing completely. Device-related regurgitation may happen when a wire, called a lead, from a pacemaker or defibrillator crosses the tricuspid valve.
Tricuspid valve regurgitation may cause no symptoms. Some people with severe disease may not have symptoms for years. Your healthcare team may find the condition when doing echocardiograms for another reason.
Symptoms of tricuspid valve regurgitation may include:
Symptoms may be caused by the tricuspid valve leak, right-sided heart failure or another heart condition.
Make an appointment if you get tired very easily or feel short of breath with activity. You may need to see a doctor trained in heart conditions, called a cardiologist.
To understand the causes of tricuspid valve regurgitation, it may help to know how the heart and heart valves typically work.
A typical heart has four chambers.
Four valves open and close to keep blood flowing in the correct direction. These heart valves are:
The tricuspid valve is between the heart's two right chambers. It has three thin flaps of tissue, called cusps or leaflets. These flaps open to let blood move from the upper right chamber to the lower right chamber. The valve flaps then close tightly so blood doesn't flow backward.
In tricuspid valve regurgitation, the tricuspid valve doesn't close tightly. So, blood may leak backward from the lower right heart chamber, called the right ventricle, into the upper right heart chamber, called the right atrium.
Tricuspid valve regurgitation can happen with mitral valve regurgitation. When more than one valve is involved, an echocardiogram helps your care team understand what is happening with each valve and the effects on heart-chamber size and pumping function.
Mitral valve disease also may raise pressure in the main veins in the lungs and contribute to secondary tricuspid regurgitation.
Causes of tricuspid valve regurgitation include:
Some tests or treatments for other conditions can affect the tricuspid valve. These include:
A risk factor is something that raises your chance of developing a health condition.
Things that can raise the risk of tricuspid valve regurgitation include:
Complications of tricuspid valve regurgitation may depend on how severe the condition is. Possible complications include:
Tricuspid valve regurgitation may cause no symptoms. Healthcare professionals may find it when doing imaging tests of the heart for other reasons.
To diagnose tricuspid valve regurgitation, a healthcare professional asks questions about your symptoms and medical history. The health professional does a physical exam and may check if you have bulging or strongly pulsing neck veins, swollen legs or belly, or an enlarged or tender liver. These findings can mean there is right-sided heart failure.
The healthcare professional listens to your heart using a device called a stethoscope. A whooshing sound called a heart murmur may be heard near the lower left or right edge of the breastbone or just below it. The murmur may become louder as you breathe in, but it can be faint or absent.
To learn if you have tricuspid valve regurgitation, your healthcare team does tests to check your heart and heart valves. The tests can show how severe any valve disease is and help your care team learn the cause. They also can show the size and pumping function of the right side of the heart, estimate pressure in the lung arteries and find other heart conditions.
Tests to diagnose tricuspid valve regurgitation may include:
The test also helps the care team find out the cause and how severe your condition is. It also shows whether the right side of the heart is enlarged, how well the right ventricle pumps and whether pressure in the lungs may be high. The care team may look for other heart disease too.
There are different types of echocardiograms. A standard echocardiogram is called a transthoracic echocardiogram (TTE). It makes pictures of the heart from outside the body. A TTE is often the first test used to diagnose tricuspid valve regurgitation.
Sometimes, a healthcare professional may need a more detailed echocardiogram to better see the tricuspid valve when the cause of the leak isn't clear, or to help plan treatment. This test is called a transesophageal echocardiogram (TEE). It uses a probe that goes mouth into the esophagus. That's the tube that connects the throat to the stomach, called the esophagus. From the esophagus the probe takes detailed pictures of the heart. The test may make 3D pictures of the heart. It also may show how a pacemaker or defibrillator wire affects the valve. The type of echocardiogram you have depends on the reason for the test and your overall health.
An echocardiogram report may describe the leak as trace, mild, moderate or severe. These are grades. Trace tricuspid regurgitation means that the test detected a very small amount of backward blood flow. Trace or mild leakage with little effect on circulation is commonly seen when the valve structure is typical. The care team considers the rest of the echocardiogram when deciding what the finding means.
The severity grade of tricuspid valve regurgitation describes how much blood leaks backward through the tricuspid valve. This grade is measured mainly with an echocardiogram. The echocardiogram uses several measurements and not only one finding.
To decide if tricuspid valve regurgitation is mild, moderate or severe, your care team uses several echocardiogram measurements. To plan your treatment and follow-up care, the team considers the grade, your symptoms and the cause of the leak. The team also considers the size of the right heart chambers, the pumping function, pressure in the lung arteries and whether you have other heart conditions.
Tricuspid valve regurgitation does not get worse for everyone who has it. Moderate or severe tricuspid valve regurgitation can progress over time, but progression varies. Follow-up depends on the starting grade, cause, symptoms and effects on the right side of the heart.
Treatment for tricuspid valve regurgitation depends on its cause, severity, symptoms, how the right side of the heart is responding and related heart or lung conditions. The goals are to:
Tricuspid valve regurgitation treatment may include:
The exact treatment depends on your symptoms and how severe the valve disease is. Some people with mild tricuspid valve regurgitation only need regular health checkups and never need surgery. Your healthcare team tells you how often you need appointments.
A trace leak with no symptoms or heart changes may not need follow-up. Mild or moderate tricuspid valve regurgitation may be checked over time based on its cause, symptoms, severity and effects on the right side of the heart. Your care team decides how often you need follow-up appointments or echocardiograms.
Treatment for secondary tricuspid valve regurgitation focuses partly on the condition causing the leak. This may include treating heart failure, lowering pressure in the lung arteries when needed, treating left-sided heart disease and managing atrial fibrillation.
You may need supplemental oxygen if low blood oxygen contributes to pulmonary hypertension and secondary tricuspid valve regurgitation.
Your healthcare professional may suggest medicines to control symptoms of tricuspid valve regurgitation. Medicines also may be used to treat the cause of the condition.
Some medicines used for tricuspid valve regurgitation include:
You may need surgery to repair or replace a diseased or damaged tricuspid valve.
Doctors may do tricuspid valve repair or replacement as open-heart surgery or a surgery with smaller cuts, called minimally invasive heart surgery. Sometimes, doctors may treat tricuspid valve regurgitation using thin, flexible tubes called catheters.
You may need tricuspid valve repair or tricuspid valve replacement surgery if:
When possible, your care team may recommend surgery or other procedures before severe weakness in the right ventricle or lasting liver or kidney damage develops.
Types of transcatheter procedures to treat tricuspid valve regurgitation include:
Tricuspid transcatheter edge-to-edge repair (T-TEER). Your healthcare professional may suggest T-TEER if you have severe symptoms despite medical treatment and face a high risk of complications from surgery. Your care team also considers your valve's structure and whether a clip can be placed safely. This treatment uses tubes called catheters and a clip to fix a leaky tricuspid valve. The clip brings the valve flaps closer together so less blood goes backward. Open-heart surgery is not needed for T-TEER.
Research found that T-TEER reduced leakage and improved health status and quality of life. At two years, it also reduced repeated heart failure hospitalizations compared with medical therapy alone. Death rates were similar between the groups.
Types of heart valve surgeries to treat tricuspid valve regurgitation include:
Tricuspid valve repair. Surgeons recommend valve repair when possible. It preserves the existing heart valve. It also might reduce the need for long-term use of blood thinners.
Tricuspid valve repair usually is done during open-heart surgery. A long cut is made in the center of the chest. A surgeon may tighten or reshape the ring around the valve and repair the leaflets or supporting tissues.
If Ebstein anomaly is the cause of tricuspid regurgitation, heart surgeons may do a type of valve repair called the cone procedure. During this treatment, the surgeon separates the tricuspid valve flaps from the heart muscle. Then the surgeon rotates the flaps and attaches them again.
Tricuspid valve replacement. If the tricuspid valve can't be repaired, surgery may be needed to replace the valve. Surgeons may do tricuspid valve replacement surgery as open-heart surgery or minimally invasive surgery.
During tricuspid valve replacement, a surgeon removes the damaged or diseased valve. The surgeon replaces the valve with a mechanical valve or a valve made from biological tissue. A tissue valve is called a biological valve.
If you have a mechanical valve, you need to take blood thinners for the rest of your life to prevent blood clots. Biological tissue valves generally don't need lifelong blood thinners only because of the valve. But another condition, such as atrial fibrillation, may make this medicine necessary. Biological tissue valves can wear down over time and may need to be replaced. Together, you and your care team discuss the risks and benefits of each type of valve to decide which option fits your health needs and preferences.
After tricuspid valve repair or replacement, you need regular health checkups to make sure your heart and valve are working as they should. Your care team may recommend a baseline echocardiogram after your valve procedure. They might suggest you have regular follow-up echocardiograms depending on the type of procedure you had, your heart function, your symptoms and other heart conditions.
People who have tricuspid valve disease that's more than minor may need careful and regular checkups during pregnancy. Your care team also may suggest an evaluation before you become pregnant. This can help the care team explain any possible risks and plan coordinated care during pregnancy.
Mild or moderate tricuspid regurgitation is generally managed well during pregnancy. If you have severe tricuspid valve regurgitation, pulmonary hypertension or reduced function of your right ventricle, you may have a higher risk of right-sided heart failure or heart rhythm problems. You and your care team can work together to individualize your decisions about pregnancy based on the severity of the leak and related heart conditions.
A small tricuspid valve leak may have little or no effect on daily life in many people. Outlook varies based on whether you have symptoms, how severe the leak is, how well the right ventricle works and whether you have other heart, kidney or liver problems. No single estimate of life expectancy applies to everyone.
If you have tricuspid valve regurgitation or any type of heart disease, your healthcare team may suggest making lifestyle changes. Healthy habits don't repair the leak but can support your heart health and help manage related conditions. Your care team may suggest that you:
If you have a replacement heart valve or artificial material used in a valve repair, ask your care team if you need to take antibiotics before certain dental procedures. Preventive antibiotics may be recommended before dental work involving the gums, the roots of the teeth or a break in the lining of the mouth. The medicine helps stop germs from getting into the bloodstream and reaching the lining of the heart. An infection of the lining of the heart is called infective endocarditis.
If a healthcare professional thinks you might have tricuspid valve regurgitation, you may be referred to a doctor trained in heart disease, called a cardiologist. If you were born with a heart condition, you may see a type of heart doctor called a congenital cardiologist.
Here's some information to help you get ready for your appointment.
Writing down questions can help you make the most of your visit. For tricuspid valve regurgitation, some basic questions to ask your care team include:
Don't hesitate to ask other questions.
Your healthcare team is likely to ask you many questions. Being ready to answer them may save time to go over any questions or concerns you have. Your care team may ask:
After testing confirms a diagnosis of tricuspid or other heart valve disease, your healthcare team may tell you the stage of disease. Staging helps your care team plan the most appropriate treatment.
A grade describes how much blood leaks backward through the valve. The stage of heart valve disease depends on many things, including the grade, along with symptoms, disease severity, the structure of the valve or valves, and blood flow through the heart and lungs.
Heart valve disease is staged into four basic groups:
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