Pulmonary valve stenosis
|Pulmonary valve stenosis|
|Classification and external resources|
Pulmonary valve stenosis
|ICD-10||I37.0, I37.2, Q22.1|
Pulmonary valve stenosis is a heart valve disorder 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. 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. Both stenosis of the pulmonary artery and pulmonary valve stenosis are causes of pulmonic stenosis.
Symptoms and Signs
Symptoms include jugular vein distension, 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 and have no negative symptoms. If stenosis is severe, sudden fainting or dizziness many occur when exercising. An enlarged liver (hepatomegaly) and swelling in the legs (edema) may also be apparent.
The initial evaluation of pulmonary valve stenosis involves echocardiography. The degree of stenosis is typically determined by the peak pressure gradient across the valve. Pulmonary stenosis is mild if the valve area is larger than 1.0 cm2 per square meter and the trans-valvular gradient is 30-50 mmHg, or the peak RV systolic pressure is less than 75 mmHg. The stenosis is moderate if valve area is 0.5-1.0 cm2 per square meter, trans-valvular gradient is 50-75 mmHg, or right ventricle systolic pressure is 75-100 mmHg. It is severe when the valve area is less than 0.5 cm2, and the gradient is more than 75 mmHg.
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, depending on the case.
- Edmund Kenneth Kerut, Elizabeth F. McIlwain, Gary D. Plotnick (1996). Handbook of Echo-Doppler Interpretation. Armonk, NY, U.S.A.: Futura. pp. 115–6. ISBN 0-87993-636-3.
- Overview at American Heart Association
- Pulmonary Stenosis information from Seattle Children's Hospital Heart Center
- Animation of pulmonary stenosis from AboutKidsHealth.ca
- Echocardiographic assessment of Pulmonary valve stenosis from WikiEcho
- Xray and CT of Pulmonic Stenosis Radiologic Diagnosis