Tricuspid regurgitation (TR), refers to the failure of the heart's tricuspid valve to close properly during systole. As a result, with each heart beat some blood passes from the right ventricle to the right atrium, the opposite of the normal direction. Tricuspid regurgitation occurs in roughly less than 1% of people and is usually asymptomatic, but may also be a feature of pulmonary hypertension and right-sided heart failure.

Signs and symptoms:
Tricuspid insufficiency may be asymptomatic, especially if right ventricular function is well preserved. Signs and symptoms are generally those of right-sided heart failure, such as ascites, an enlarged liver, edema and jugular venous distension. Vague upper abdominal discomfort (from a congested liver), and fatigue (due to diminished cardiac output) can all be present to some degree.

On examination, the jugular venous pressure is usually elevated, and 'CV' waves can be seen. It features prominent V waves and rapid y descents in jugular venous pressure Peripheral edema is often found. In severe cases, there may be ascites and even cirrhosis (so-called 'cardiac cirrhosis').

Tricuspid insufficiency may lead to the presence of a pansystolic heart murmur. Such a murmur is usually of low frequency and best heard low on the lower left sternal border. It tends to increase with inspiration, and decrease with expiration and Valsalva maneuver.However, the murmur may be inaudible reflecting the relatively low pressures in the right side of the heart. A third heart sound may also be present, also heard best with inspiration at the left lower sternal border.Parasternal heave may be felt along the left lower sternal border as well.
Atrial fibrillation is usually present.