Pulmonary valve stenosis is a valvular heart disease in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. This results in the reduction of flow of blood to the lungs. Valvular pulmonic stenosis accounts for 80% of right ventricular outflow tract obstruction.^[1] While the most common cause of pulmonary valve stenosis is congenital heart disease, it may also be due to rheumatic heart disease or a malignant carcinoid tumor.^[1]

Symptoms

Symptoms include jugular venous distention, cyanosis (usually visible in the nailbeds), right ventricular hypertrophy and general symptoms of lowered oxygenation of the blood. When the stenosis is mild, it can go unnoticed for many years. If stenosis is severe, you may see sudden fainting or dizziness if exercised too much, you may also experience an enlarged liver (hepatomegaly) and swelling in the legs (edema).

Evaluation

The initial evaluation of pulmonary valve stenosis involves echocardiography. The degree of stenosis is typically determined by the peak pressure gradient across the valve.^[1] If the peak gradient across the valve is greater than 50 mmHg, intervention is generally warranted. If the peak gradient is < 25 mmHg, no intervention is generally needed. If the gradient is between 25 and 50 mmHg, it is a gray area.

Treatment

Valve replacement or surgical repair (depending upon whether the stenosis is in the valve or vessel) may be indicated. If the valve stenosis is of congenital origin, balloon valvuloplasty is another option.

References

1. ↑ ^{a b c}

External links

• Overview at University of Maryland
• Overview at American Heart Association
• Pulmonary Stenosis information from Seattle Children's Hospital Heart Center
• Animation of pulmonary stenosis from AboutKidsHealth.ca

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