Tricuspid stenosis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohammed Salih, M.D. Syed Musadiq Ali M.B.B.S.[2] Aditya Ganti M.B.B.S. [3]


Tricuspid stenosis (TS) staging sections into categories A, B, C, D. Stages C (without symptoms) and D (with symptoms). When valve and/or chordal thickening and calcification are evident, there are additional findings indicative of severe TS, for example, pressure gradient greater than or equal to 5 mm Hg, pressure half-time greater than or equal to 190 milliseconds, valve area less than or equal to 1.0 cm^2, associated moderate right atrial enlargement, and inferior vena cava dilatation.


Tricuspid stenosis (TS) is staged based on the valve anatomy and hemodynamics, and the hemodynamic consequences. No criteria for Stage A or B were included in the 2014 American Heart Association/American College of Cardiology valve guidelines. Stage C is defined as severe TS without symptoms. Stage D is defined as severe TS with symptoms.[1][2]

Stage Definition Valve anatomy Valve hemodynamics Hemodynamic consequences Symptoms
C, D Severe TS Thickened, distorted, calcified leaflets
  • T ½ ≥190 ms 
  • Valve area ≤1.0 cm2
Right atrial / Inferior vena cava enlargement
  • Stage C-No symptoms
  • Stage D-Symptoms variable and dependent on the severity of associated valve disease and degree of obstruction


  1. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP, Guyton RA; et al. (2014). "2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines". J Am Coll Cardiol. 63 (22): e57–185. doi:10.1016/j.jacc.2014.02.536. PMID 24603191.
  2. Baumgartner, Helmut; Hung, Judy; Bermejo, Javier; Chambers, John B.; Evangelista, Arturo; Griffin, Brian P.; Iung, Bernard; Otto, Catherine M.; Pellikka, Patricia A.; Quiñones, Miguel (2009). "Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice". Journal of the American Society of Echocardiography. 22 (1): 1–23. doi:10.1016/j.echo.2008.11.029. ISSN 0894-7317.

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