(A) Transthoracic echocardiogram in a modified apical four chamber view showing thickened and rigid tricuspid valve (TV) leaflets in an abnormal, fixed.

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(A) Transthoracic echocardiogram in a modified apical four chamber view showing thickened and rigid tricuspid valve (TV) leaflets in an abnormal, fixed open position during systole. (A) Transthoracic echocardiogram in a modified apical four chamber view showing thickened and rigid tricuspid valve (TV) leaflets in an abnormal, fixed open position during systole. Endocardial plaque formation of the subvalvar apparatus is also notable. (B) Colour flow Doppler imaging in the same view shows severe tricuspid regurgitation through a wide regurgitant orifice. MV, mitral valve; RA, right atrium; RV, right ventricle. David J Fox, and Rajdeep S Khattar Heart 2004;90:1224-1228 Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.