Diagnosis (right chronic insufficiency)

How to diagnose right chronic insufficiency

Upon conducting a heart examination, it is noted that there is tachycardia, the heart sounds have become muted, there are galloping sounds and systolic rumours in the vicinity of the xiphoid process, which all indicate a functional insufficiency of the tricuspid valve. In the epigastric region one can observe the pulsations of the enlarged right ventricle. As a consequence of venous stasis, the jugulars are swollen, the venous pressure is high, and the speed of blood circulation is slow.

Following a radiological examination: The right ventricle, and at times the right atrium are enlarged. The infundibulum (a conical pouch formed from the upper and left angle of the right ventricle in the chordate heart) appears more swollen. There are other examinations that can be performed in order to visualize the enlarged heart, but the radiological examination is the most effectively clear method that can be used to set a diagnosis.

The electrocardiogram exhibits hypertrophy of the right ventricle, which oftentimes can be accompanied by a blockage of the right branch.

Global cardiac insufficiency

Global cardiac insufficiency occurs as a consequence of the combination of the insufficiency of the left and right ventricles. There are no particular symptoms, but more often than not the symptoms of the insufficiency of the right ventricle (with peripheral venous stasis) are more predominantly visible. Usually when the insufficiency of the right ventricle emerges, the patient feels better, because symptoms such as cardiac asthma and acute pulmonary edema disappear.

Hypo diastolic cardiac insufficiency

Hypo diastolic cardiac insufficiency is mostly due to the fact that the heart cannot become sufficiently filled with blood, as often occurs in exudative pericarditis and especially for constrictive pericarditis. Patients appear to have cyanosis, swelling of the jugular veins, hepatomegaly, ascites (which usually appears before the edemas in the lower extremities), rise in venous pressure, etc. These are signs of the stasis in the systemic  circulation, whereas there are no changes for the pulmonary circulation.

Medically Reviewed by a doctor on 19 Jun 2018
Medical Author: Dr. med. Diana Hysi