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©2013 UpToDate ® Print Email ACC/AHA guideline summary: Evaluation of tricuspid regurgitation (TR) in adolescents and young adults Class I - There is evidence and/or general agreement that the following tests should be obtained in adolescents and young adults with TR • Electrocardiogram at the initial evaluation and serially every one to three years, depending upon severity. • Chest radiograph at the initial evaluation and serially every one to three years, depending upon severity. • Doppler echocardiography at the initial evaluation and serially every one to three years, depending upon severity. • If an atrial communication is present, pulse oximetry at rest and/or during exercise at the initial evaluation and serially every one to three years, depending upon severity. Class IIa - The weight of evidence or opinion is in favor of the usefulness of the following tests in adolescents and young adults with TR • Electrophysiology study for symptomatic atrial arrhythmias. • Exercise testing at the initial evaluation and serially every one to three years. Class IIb - The weight of evidence or opinion is less well established for the usefulness of the following tests in adolescents and young adults with TR • Among asymptomatic patients, Holter monitoring at the initial evaluation and serially every one to three years. Data from: Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing committee to revise the 1998 guidelines for the management of patients with valvular heart disease). J Am Coll Cardiol 2006; 48:e1.