Which of the following is seen in a patient with tricuspid Incompetence: September 2005

Ans. A: Hepatic pulsation Physical findings in tricuspid incompetence: Jugular venous distention with a prominent V wave and rapid y descent. Diminished peripheral pulse volume secondary to impaired forward blood flow: Pulmonary rales if the tricuspid regurgitation is associated with LV dysfunction or mitral stenosis RV heave and S 4 gallop that increases with inspiration Ascites, marked hepatomegaly, systolic pulsation of liver and positive hepatojugular reflex. Peripheral edema Atrial fibrillation A high-pitched pansystolic murmur (loudest in the fouh intercostal space in the parasternal region). The murmur is usually augmented during inspiration and is reduced in intensity and duration in the standing position and during a Valsalva maneuver (Carvallo's sign). A sho, early diastolic flow rumble may be present due to increased flow across the tricuspid valve.