Investigations
- ECG - often atrial fibrillation and right ventricular hypertrophy or right bundle branch block.
- chest x-ray - cardiomegaly (enlarged right atrium, right ventricle).
- echocardiography - right atrial and right ventricular enlargement with abnormal tricuspid cusps. Doppler scanning reveals regurgitation.
- cardiac catheterization and angiography - thickened cusps, tricuspid regurgitation.
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