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Anatomy · Heart & blood vessels

Tricuspid valve

Three cusps, right side of the heart

Heart · right atrioventricular valve

The valve between the right atrium and the right ventricle, also called the right atrioventricular valve. It has three cusps, anterior, posterior and septal, tethered by chordae tendineae to three papillary muscles, and it has the largest orifice of the four heart valves.

How to spot them

  • ▸Three leaflets: anterior (largest), posterior and septal
  • ▸Chordae attach to anterior, posterior and septal papillary muscles; the anterior one carries the moderator band
  • ▸The septal leaflet sits against the interventricular septum, close to the atrioventricular node
  • ▸Best heard at the lower left sternal edge

What to know

The valve between the right atrium and right ventricle, with three cusps

Tricuspid valve — the right atrioventricular valve.

Its three cusps are called anterior, posterior and septal

Tricuspid valve.

Has the largest orifice of the four heart valves, wider than that of its left-sided counterpart

Tricuspid valve.

A congenital displacement of its septal and posterior leaflets toward the apex, with an 'atrialised' right ventricle, is named after a German physician

Tricuspid valve — Ebstein's anomaly.

Chordae tendineae hold it to three papillary muscles, one of which, the anterior, connects to the moderator band

Tricuspid valve — anterior, posterior and septal papillary muscles.

Infection of this valve is the typical form of endocarditis in people who inject drugs

Tricuspid valve — right-sided endocarditis.

Its regurgitation makes the jugular veins show giant v waves and the liver pulsate

Tricuspid valve — tricuspid regurgitation.

Key ideas

  • Right-sided pressures are low, so the valve and its supporting cords are thinner than the mitral's.
  • Its septal leaflet lies next to the membranous septum and the conducting tissue: procedures near it risk heart block.

Quick-fire facts

  • •Three cusps and three papillary muscles, versus two of each in the mitral valve.
  • •Largest of the four heart valves by orifice area.
  • •The moderator band (septomarginal trabecula) carries part of the right bundle branch across the ventricle from septum to the anterior papillary muscle.
  • •Ebstein's anomaly, described by Wilhelm Ebstein in 1866, involves apical displacement of the septal leaflet.
  • •The tricuspid area for auscultation is the lower left sternal edge, fourth to fifth intercostal space.
  • •Its closure contributes the T1 component of the first heart sound, following the mitral component.
  • •Functional tricuspid regurgitation is common when the right ventricle dilates.
  • •The valve opens when right atrial pressure exceeds right ventricular pressure in diastole.

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Sources