title: Acquired tricuspid incompetence in children: pitfalls in the clinical diagnosis of its aetiology.
abstract: Pitfalls in the clinical diagnosis of the aetiology of acquired tricuspid incompetence in children were exemplified in five patients. In three of them acute staphylococcal endocarditis, the cause of the valve defect, was obscured during life by co-existing sickle cell haemoglobinopathy, acute leukaemia and rheumatic mitral valvulitis, respectively. The fourth and fifth patients had clinical features suggestive of right ventricular endomyocardial fibrosis but necropsy revealed that the tricuspid incompetence was caused by dilated cardiomyopathy and constrictive pericarditis respectively. This series illustrates the need to suspect bacterial endocarditis if a child presents with signs of infection and valvular incompetence, and also dispels the widespread belief that pericardial constriction does not cause tricuspid incompetence.
mesh_terms: D009202:Cardiomyopathies / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010494:Pericarditis, Constrictive / Q000150:complications / Q000175:diagnosis*; D013203:Staphylococcal Infections; D014262:Tricuspid Valve Insufficiency / Q000175:diagnosis / Q000209:etiology*