Pulsatile temporal vein caused by severe tricuspid regurgitation
3607
Editorial
process? Clinical, laboratory, and transesophageal echocardiographic correlates
of thoracic aortic dimensions in the population with implications for thoracic
aortic aneurysm formation. J Am Coll Cardiol 2003;42:1076–1083.
19. Cuspidi C, Meani S, Valerio C, Esposito A, Sala C, Maisaidi M, Zanchetti A, Mancia
G. Ambulatory blood pressure, target organ damage and aortic root size in nevertreated essential hypertensive patients. J Hum Hypertens 2007;21:531–538.
20. Vasan RS, Larson MG, Levy D. Determinants of echocardiographic aortic root
size. The Framingham Heart Study. Circulation 1995;91:734–740.
21. Stritzke J, Linsel-Nitschke P, Markus MR, Mayer B, Lieb W, Luchner A, Doring A,
Koenig W, Keil U, Hense HW, Schunkert H, MONICA/KORA Investigators.
Association between degenerative aortic valve disease and long-term exposure
..
..
..
..
..
..
..
..
..
..
..
..
.
to cardiovascular risk factors: results of the longitudinal population-based
KORA/MONICA survey. Eur Heart J 2009;30:2044–2053.
22. Carabello BA, Paulus WJ. Aortic stenosis. Lancet 2009;373:956–966.
23. Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Denaxas S,
White IR, Caulfield MJ, Deanfield JE, Smeeth L, Williams B, Hingorani A,
Hemingway H. Blood pressure and incidence of twelve cardiovascular diseases:
lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million
people. Lancet 2014;383:1899–1911.
24. Fewell Z, Davey Smith G, Sterne JA. The impact of residual and unmeasured
confounding in epidemiologic studies: a simulation study. Am J Epidemiol 2007;
166:646–655.
doi:10.1093/eurheartj/ehy568
Online publish-ahead-of-print 4 October 2018
....................................................................................................................................................
Pulsatile temporal vein caused by severe tricuspid regurgitation
Victor Duerst, Georg Noll, and Patric Biaggi*
Heart Clinic Zurich, Witellikerstrasse 40, 8032 Zurich, Switzerland
* Corresponding author. Tel: 141 44 387 97 00, Fax: 141 44 387 97 10, Email:
A 79 year old woman was admitted for progressive weight gain, leg oedemas, and
abdominal tension. On examination in supine
position, a soft and compressible temporal
vessel was observed (Panel A, blue circle).
The vessel showed pulsations following
those of the severely distended jugular veins
(Panel A, blue arrows; Supplementary mate
rial online, Video S1). In upright position, the
vessel collapsed, while the distension and pulsation of the jugular veins remained (Panel B;
Supplementary material online, Video S2).
Having the patient sit up is a simple manoeuvre to rule out the differential diagnosis of
arteritis temporalis, where the pulsatile
arteries are hard, non-compressible, often
tender, and independent of the patient’s position. Echocardiography confirmed the clinical
suspicion of torrential tricuspid regurgitation,
and successful tricuspid valve replacement
was performed. Untreated severe tricuspid
regurgitation is associated with poor clinical
outcome. As the range of therapeutic
options for this often neglected disease is
expanding, its clinical recognition becomes
even more important.
Supplementary material is available at European Heart Journal online.
C The Author(s) 2018. For permissions, please email: .
Published on behalf of the European Society of Cardiology. All rights reserved. V
CARDIOVASCULAR FLASHLIGHT
(...truncated)