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©2013 UpToDate ® Email Apical 4 chamber echocardiogram with color Doppler showing tricuspid regurgitation The four chamber view from a 2-D echocardiogram with color flow Doppler shows significant tricuspid regurgitation with a dilated right atrium. There is a prosthetic mitral valve suggesting that the etiology for tricuspid regurgitation is pulmonary hypertension resulting from previous mitral valve disease. Courtesy of Thomas Binder, MD. University of Vienna.