Tricuspid regurgitation can be broadly divided into hypertensive and non-hypertensive, depending on the right ventricular pressure, whether it is elevated or not. Tricuspid regurgitation is best assessed in the apical four chamber view on echocardiography. This is because the direction of the jet and the Doppler beam are parallel to each other in this view. Hence the estimation of the jet velocity will be more accurate in this view. The more distally the jet extends from the tricuspid valve into the right atrium, the more severe the regurgitation. A larger jet area on colour Doppler also indicates a severer regurgitation.
Tricuspid regurgitation jet seen on colour Doppler echocardiography from the apical four chamber view. RV right ventricle; LV left ventricle; LA left atrium; RA right atrium. The mosaic colour indicates high velocity with aliasing while the proximal most portion of the jet in right atrium is blue indicating flow away from the transducer. The tricuspid regurgitation in this case was moderate to severe. The right atrium and right ventricle are dilated due to pulmonary hypertension. Left atrium is also dilated due to associate mitral regurgitation in this case.