When it comes to the tricuspid valve, echocardiography is the go-to tool for assessing its function and detecting any potential issues, including tricuspid regurgitation (TR). One often-overlooked cause of TR is lead-induced TR, which can occur in patients with pacemakers or implantable cardioverter-defibrillators (ICDs). The culprit here is usually the lead itself, which can interfere with the tricuspid valve's normal functioning, leading to regurgitation. On echocardiography, the RV inflow view is particularly useful for assessing the tricuspid valve and detecting lead-induced TR. This view allows us to visualize the tricuspid valve leaflets and the lead's interaction with them. If the lead is impinging on the valve or interfering with leaflet coaptation, it can cause TR. We might see the lead entangled with the tricuspid valve leaflets, restricting their motion or preventing proper closure. Color Doppler can help us detect the presence and severity of TR, which can range f...