Pulmonary valve stenosis
Pulmonary valve stenosis
Pulmonary valve stenosis is a condition in which the flow of blood from your heart to your lungs is slowed by a deformed pulmonary valve, or a deformity above or below the valve.
Adults occasionally have the condition as a complication of another illness, but most of the time, pulmonary valve stenosis develops before birth.
Pulmonary valve stenosis ranges from mild and without symptoms to severe and debilitating. Mild pulmonary stenosis doesn't usually worsen over time, but moderate and severe cases may get worse and require surgery. Fortunately, treatment is highly successful, and most people with pulmonary valve stenosis can expect to lead normal lives.
Pulmonary valve stenosis symptoms may include:
Pulmonary valve stenosis symptoms vary, depending on the extent to which the valve is obstructed. People with mild pulmonary stenosis might have symptoms only while exercising or have none at all.
When to see a doctor
If you have pulmonary stenosis or another heart problem, prompt evaluation and treatment can help reduce your risk of complications.
Pulmonary valve stenosis usually occurs when the pulmonary valve doesn't grow properly during fetal development. Other heart abnormalities are often present at birth (congenital) in babies who have pulmonary valve stenosis. It's not known what causes the valve to develop abnormally.
Normal pulmonary valve anatomy
What happens in pulmonary valve stenosis
Other contributing conditions
Although pulmonary valve stenosis is the most common type of pulmonary stenosis, there are two other types of pulmonary stenosis:
In pulmonary stenosis, the flow of blood from the right ventricle to the pulmonary artery is obstructed by narrowing at the pulmonary valve. The greater the constriction, the harder the right ...
Because most causes of pulmonary valve stenosis develop before birth, there aren't many known risk factors. However, certain conditions can increase your risk of developing pulmonary valve stenosis, including:
Cases of mild to moderate pulmonary stenosis generally don't cause complications. However, severe pulmonary stenosis may be associated with the following:
Preparing for your appointment
You're likely to start by seeing your family doctor, a general practitioner or your child's physician. However, you'll probably then be referred to a doctor who specializes in heart conditions (cardiologist).
Because appointments can be brief, and there's often a lot of ground to cover, it's a good idea to arrive well prepared. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For pulmonary valve stenosis, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
Tests and diagnosis
Pulmonary stenosis is often diagnosed in childhood, but sometimes it isn't detected until later in life. Your doctor may suspect pulmonary stenosis if he or she hears a heart murmur in the upper left area of your chest during a routine checkup. Your doctor may then use a variety of tests to confirm the diagnosis:
Treatments and drugs
Some cases of pulmonary stenosis are mild and don't require treatment except for routine checkups. However, if your case is more serious, you may need either balloon valvuloplasty or open-heart surgery.
The decision to perform a balloon valvuloplasty or open-heart surgery depends on the extent to which the pulmonary valve is obstructed. Pulmonary stenosis is classified as mild, moderate or severe, depending on a measurement of the blood pressure difference between the right ventricle and pulmonary artery.
The most common side effect of a balloon valvuloplasty is valve regurgitation, in which some blood leaks backward through the pulmonary valve after the balloon is in place. But the benefits associated with the procedure usually outweigh the risk of valve regurgitation. As with most procedures, there is a risk of bleeding, infection or blood clots.
During the surgery, your doctor repairs the pulmonary artery or the valve to allow blood to pass through more easily. In certain cases, your doctor may replace the pulmonary valve with an artificial valve.
Some people with pulmonary stenosis have other congenital heart defects, and these may be repaired at the time of surgery. As with balloon valvuloplasty, there is a slight risk of bleeding, infection or blood clots associated with the surgery.
Recommendations from the American College of Cardiology and the American Heart Association advise that antibiotics are no longer necessary for people who have only pulmonary stenosis. Instead, antibiotics are reserved for people at high risk of serious complications of infective endocarditis, such as those who have other heart conditions or artificial valves, or who've had repair with prosthetic material.
If you've had your pulmonary valve replaced, you may still need preventive antibiotics before dental and other procedures. Talk to your doctor for specific recommendations in your case.
Last Updated: 2009-12-11
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