Pseudo tricuspid regurgitation: Unusual etiology of a pulsating liver

A pulsating liver is characteristic of significant tricuspid regurgitation [Cha SD, Desai RD, Gooch AS, et al. Diagnosis of severe tricuspid regurgitation. Chest 1982; 82(6):726–731.]. An adult man with known tricuspid atresia presented with clinical features of marked tricuspid regurgitation. In the presence of tricuspid atresia, tricuspid regurgitation is an impossibility. Electrocardiogram, echocardiogram, phonocardiogram, and pulse tracings were obtained to confirm the physical examination and better document the pathophysiology.