This early report describes a previously unrecognized syndrome of tricuspid regurgitation following inferior myocardial infarction, likely due to right ventricular papillary muscle dysfunction.
Tricuspid insufficiency may complicate inferior MI; case report leaves open right ventricular papillary muscle dysfunction as etiology.
Isolated tricuspid incompetence is uncommon and is usually tolerated well.¹⁻³It has been reported after trauma,¹⁻⁴with papillary muscle rupture after myocardial infarction,⁵after bacterial endocarditis,⁶,⁷after rheumatic fever,⁸and as a congenital anomaly.⁹In addition, incompetence of the valve after dilatation of the annulus may result from pulmonary hypertension and subsequent severe right ventricular failure.¹⁰In this report, we present two patients with tricuspid insufficiency occurring after inferior wall myocardial infarction and possibly caused by right ventricular papillary muscle dysfunction, a syndrome not previously recognized.¹¹ PATIENT SUMMARIES Patient 1.— A 68-year-old retired farmer was admitted to Vanderbilt University Hospital because of persistent ascites. He had been well until four years earlier, when he suffered an inferior wall myocardial infarction. Two years after an uneventful recovery, he noted abdominal swelling; this subsequently proved refractory to outpatient therapy with digitalis, sodium restriction, and
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Russell G. McAllister (1976) studied this question.
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