AF related severe tricuspid regurgitation: a case report
Published in the Journal of Cardiology Cases, the authors present a case of a patient with severe tricuspid regurgitation (TR) due to atrial fibrillation (AF) in whom hemodynamic monitoring played a role in the selection of the management strategy.

An 81-year-old man with chronic AF was admitted due to worsening heart failure. Echocardiography showed the dilation of bilateral atria and a right ventricle with severe TR. The right heart catheterization demonstrated the elevation and equalization of diastolic pressures of four cardiac chambers with impaired diastolic filling pattern, which are hallmarks of pericardial constriction due to CP.

Of note, the CP-like hemodynamics were completely normalized by 10 days of medical therapies including diuretics and carperitide. After his discharge and over a 1-year follow-up, he has never experienced worsening heart failure and remained NYHA class II with moderate TR.

Key Points
• Medical management targeted at volume reduction and vasodilation can be a therapeutic option for CP-like hemodynamics in isolated severe TR related to AF

• Repeated hemodynamic assessment is an appropriate tool to help in understanding of the CP-like physiology caused by severe TR based on chronic AF