Tricuspid regurgitation (TR) is a condition in which blood flows backwards through the tricuspid valve into the right atrium during the heart's relaxation phase (diastole). This can occur when the tricuspid valve becomes damaged or weakened, allowing the blood to leak back into the right atrium instead of being pumped into the right ventricle.

There are several key clinical pearls that are important to consider when evaluating and managing individuals with TR:

1. TR can be caused by a variety of factors, including rheumatic fever, endocarditis, and congenital heart defects. It can also occur as a result of damage to the tricuspid valve from conditions such as pulmonary hypertension or a heart attack.
2. Symptoms of TR may include shortness of breath, fatigue, and swelling in the legs, ankles, and abdomen. In severe cases, TR can lead to heart failure and other complications.
3. TR is typically diagnosed based on a combination of clinical presentation, physical examination, and imaging studies such as echocardiography.
4. Treatment for TR may involve medications to manage symptoms and improve heart function, as well as lifestyle modifications such as quitting smoking and limiting fluid intake.
5. In severe cases, treatment may also involve surgery to repair or replace the tricuspid valve.