Pulmonary valve stenosis
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Pulmonary valve stenosis is a condition where there is a narrowing between the valve in the right ventricle and pulmonary artery which causes a decrease in blood flow through the valve due to the stiffness or thickness of the valve flaps (cusps).
This condition commonly results from congenital heart defects. The heart condition can exist on its own or in connection with other congenital abnormalities of the heart and may be mild or severe. Adults, however, may experience pulmonary valve stenosis as a complication of another condition.
Mild pulmonary valve stenosis might be asymptomatic and occasionally need medical interventions. The valve may need to be repaired or replaced in cases of moderate and severe pulmonary valve stenosis.
Symptoms
Mild pulmonary stenosis may be asymptomatic. People with moderate and severe pulmonary stenosis could experience symptoms for the first time when exercising. The signs and symptoms of pulmonary valve stenosis depend on the amount of blood flow that has been blocked.
Signs and symptoms of pulmonary valve stenosis can include:
- Heart murmur
- Breathing difficulties or shortness of breath
- Fatigue or weakness
- Chest pain
- Fainting or loss of consciousness
Among other congenital heart problems, pulmonary valve stenosis can cause infants to have bluish discoloration of the skin (cyanotic). Infants with a severe obstruction may not gain weight at the expected rate or fail to thrive.
If the patient is having any signs or symptoms, please consult the doctor. The early diagnosis and treatment help lower the risk of complications of pulmonary stenosis.
Causes
The precise cause of pulmonary valve stenosis is still not known. The most common cause of pulmonary valve stenosis is a congenital heart defect. Inadequate pulmonary valve development occurs as the newborn child is growing inside the womb.
The pulmonary valve is composed of three flaps (cusps), which are thin bits of tissue. Every time the heart beats, your cusps open and close, ensuring that blood flows in the proper directions. However, during the pulmonary valve stenosis, the valve doesn’t open properly due to that one or more cusps being stiff or thickened, or fused together.
The right ventricle’s pressure rises as blood struggles to pass through the narrower opening, which makes it difficult for blood to leave the lower right heart chamber (right ventricle). The increasing pressure puts strain on the heart and eventually thickens the muscle wall of the right ventricle.
Risk factors
The following diseases or conditions can raise the risk of developing pulmonary valve stenosis:
- Rubella (German measles): Pregnancy-related German measles (rubella) increases the risk of pulmonary valve stenosis in the fetus.
- Noonan syndrome: This inherited condition affects the structure and function of the heart.
- Rheumatic fever: This strep throat complication has the potential to permanently harm the heart, particularly the heart valves and may raise the possibility of developing pulmonary valve stenosis.
- Carcinoid syndrome: A rare malignant tumor causes shortness of breath, flushing, and other signs and symptoms by releasing specific chemicals into the bloodstream. Carcinoid heart disease affects heart valves and is seen in certain individuals with this illness.
Diagnosis
Pulmonary valve stenosis is commonly diagnosed during the childhood period. However, it might not be discovered until much later in life.
When a doctor listens to your heart by using stethoscope, heart murmur can be heard. The murmur can be an initial sign of the disease.
A pulmonary valve stenosis diagnosis test could involve:
- Electrocardiogram (ECG or EKG): This rapid and painless examination captures the electrical activity of the heart. Electrodes are applied in the form of sticky patches to the arms, legs, and chest. The electrodes are connected by wires to a computer, which shows the test findings. An ECG can display the heart’s rhythm as well as potential cardiac muscle thickening indicators.
- Echocardiogram: Sound waves are used in an echocardiogram to create images of the heart, revealing the pulmonary valve’s structure, location and degree of valve narrowing as well as revealing the heart beat and its pumping.
- Cardiac catheterization: The heart is reached by inserting a thin tube (catheter) into the groin and guiding it via the blood vessels to the heart. For better X-ray visibility, dye can be administered through the catheter into the blood vessels, (coronary angiogram).
Cardiac catheterization is used to test the pressure inside the heart’s chambers and evaluate how well the heart pumps blood. The test can assess the severity of pulmonary valve stenosis by comparing the blood pressure in the right ventricle.
Other imaging tests, such as computed tomography (CT) and magnetic resonance imaging (MRI) are also used for diagnosis confirmation.
Treatment
If the patient have mild pulmonary valve stenosis with no symptoms, then only need occasional visits are needed. However, for moderate or severe pulmonary valve stenosis, a surgical procedure may be recommended. The general health of the patient and the condition of the pulmonary valve will determine what kind of procedure or if surgery may be needed.
The following heart operations and treatments are used to treat pulmonary valve stenosis:
- Balloon valvuloplasty: a flexible tube (catheter) that is inserted into the artery, typically through the groin area, and has a balloon on the tip. X-rays are utilized to assist in directing the catheter to the heart’s narrowed valve. The valve opening will be widened and the valve flaps will be separated by inflating the balloon. Afterwards, the balloon is deflated and removed.The symptoms of pulmonary valve stenosis may be lessened and blood flow through the heart may be improved with valvuloplasty. However, there is a possibility that the valve could narrow again, therefore some people might need valve repair or replacement.
- Pulmonary valve replacement: A catheter technique or open-heart surgery may be used to replace the pulmonary valve. During the procedure other congenital heart defects may also be repaired at the same time. Antibiotics must be taken before dental or surgical operations in order to prevent endocarditis in patients who have had pulmonary valve replacement.
