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Mild tricuspid stenosis often causes no symptoms. But as stenosis worsens, the heart needs to work harder to squeeze blood through the narrowing gap; this causes the right atrium to become enlarged. Eventually the enlarged atrium affects the pressure and blood flow in surrounding chambers and veins, causing fatigue, shortness of breath, cold skin, fluttering sensations and palpitations. In later stages, complications may include signs of more severe heart failure (e.g., lung congestion, fatigue at rest, fainting, swollen feet and ankles), chest pain, arrhythmias or heart attack.