Stage | Definition | Valve hemodynamics | Hemodynamic consequences | Clinical symptoms and presentation |
B | Progressive TR | - Central jet <50% RA
- Vena contracta width <0.7 cm
- ERO <0.40 cm2
- Regurgitant volume <45 mL
| | |
C | Asymptomatic severe TR | - Central jet ≥50% RA
- Vena contracta width ≥0.7 cm
- ERO ≥0.40 cm2
- Regurgitant volume ≥45 mL
- Dense continuous wave signal with triangular shape
- Hepatic vein systolic flow reversal
| - Dilated RV and RA
- Elevated RA with "c-V" wave
| - Elevated venous pressure
- No symptoms
|
D | Symptomatic severe TR | - Central jet ≥50% RA
- Vena contracta width ≥0.7 cm
- ERO ≥0.40 cm2
- Regurgitant volume ≥45 mL
- Dense continuous wave signal with triangular shape
- Hepatic vein systolic flow reversal
| - Dilated RV and RA
- Elevated RA with "c-V" wave
| - Elevated venous pressure
- Dyspnea on exertion, fatigue, ascites, edema
|