The tricuspid valve can become diseased in a couple of different ways. The most common is for it to become what we call “insufficient” or leaking, and there are different mechanisms for that. With tissue destruction, if the leaflets themselves are destroyed, whether that be by infection or rheumatic disease which is an auto-immune disorder and inflammatory condition or other inflammatory conditions, then when those leaflets are destroyed and they can no longer reach each other to close, then when the ventricle squeezes the blood will go backward into the right atrium. Over time, the right atrium will enlarge, the pressures increase in the venous system, the patient develops symptoms of swelling in their legs or fullness in their abdomen, accumulating fluid on the right side. Those symptoms persist and then the patient becomes quite ill.