Pulmonic regurgitation

Pulmonic regurgitation, also known as pulmonary regurgitation, is the backward flow of blood from the pulmonary artery, through the pulmonary valve, and into the right ventricle of the heart during diastole. While a small amount of pulmonic regurgitation may occur in healthy individuals, it is usually detectable only by an echocardiogram and is harmless. More pronounced regurgitation that is noticed through a routine physical examination is a medical sign of disease and warrants further investigation.

Signs and symptoms

Mild cases usually do not cause any symptoms. Because pulmonic regurgitation is the result of other factors in the body, any noticeable symptoms are ultimately caused by an underlying medical condition rather than the regurgitation itself. However, more severe regurgitation may contribute to right ventricular hypertrophy, and in later stages, right heart failure.

Diastolic Murmur - Early decresendo murmur. Heard best at the left lower sternal border. Pulmonary Hypertension Infective endocarditis Rheumatic heart disease Congestive abnormalities Tetralogy of malformation of the heart characterized by a defect in the septum, misplacement of the origin of the aorta, narrowing of the pulmonary artery and enlargement of the RV. Itrogenic (post surgical repair for congenital heart disease) Chest trauma Carcenoid heart disease(tumor) Prosthetic heart valve dysfunction

Causes

Pulmonary hypertension is the most common cause of excessive pulmonic regurgitation. Other possible causes include tetralogy of Fallot, infective endocarditis, and congenital absence of the pulmonary valve, carcinoid syndrome.

Treatment

Asymptomatic cases do not require treatment.

Pulmonic regurgitation is generally treated by addressing the underlying condition. In certain cases, the pulmonary valve may be surgically replaced.

References

• Lange 2008 Current Medical Diagnosis and Treatment, 47th edition pp. 298–299 ISBN 978-8-07-149430-4
• Xiushui, R., Saavedra, P., Cannistra, L. "Pulmonic Regurgitation", eMedicine, http://www.emedicine.com/med/topic1964.htm