Triscupid Valve

The atria and ventricles are separated by the tricuspid valve (3 leaf) in the right heart.

Valves act as gates ensuring unidirectional blood flow. They are located between the atria and ventricles as well as between the ventricles and the major arteries. The atrioventricular (AV) valves lie between the atria and the ventricles of the right and left heart. The ventricles eject blood through semilunar valves composed of 3 cusps.

The atria and ventricles are separated by the tricuspid valve (3 leaf) in the right heart and the bicuspid or mitral valve (2 leaf) in the left heart. Blood ejected from the ventricles pass through the semilunar valves (see Figure 1.3), the pulmonic valve into the pulmonary arteries and the aortic valve into the aorta. Pressure within a ventricle or artery catches the cusps of a valve – like a parachute – closing the valve and preventing back flow.

The valves are composed of similar components: leaflets; annulus – a fibrous ring that encircles the valve; and chordae tendaneae – fibrous ligaments that connect to the papillary muscles. The papillary muscles flex when the ventricles contract to stabilize the AV valves. Note that an MI may weaken papillary muscles or rupture the chordae tendaneae, resulting in a heart murmur.

While heart murmurs may suggest valvular pathology, heart sounds also suggest normal function. The closing of the AV valves produce the classic S1 sound, heard at the beginning of ventricle systole (‘lub’ of lub-dub). Subsequently, as the ventricles begin to relax (diastole), the semilunar valves close producing the S2 heart sound (‘dub’).

Other causes of heart murmurs include age related changes to the valves such as the formation of calcium deposits and the stenosis of the valve leaflets or cusps. An impaired mitral valve, for example, could result in reduced blood volume being ejected from the left ventricle due to regurgitation of blood back into the atrium. This can eventually lead to left atrial hypertrophy and pulmonary hypertension.

Figure 1.3 Semilunar Valve (aortic or pulmonic) and Figure 1.4 The Heart’s Valves (superior view)

The aortic and pulmonic semilunar valves are pictured in Figure 1.3. The leaves of the semilunar valves are billowed closed during ventricular diastole as arterial pressure becomes greater than the pressure within the ventricles. The semilunar valves ensure forward flow of the arterial blood ejected from the ventricles.

Figure 1.4 depicts the valves of the heart from above the heart.

1. Six Second ECG Guidebook (2012), T Barill, p. 12-14

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