[13] Pulmonary Stenosis Flashcards
What is pulmonary stenosis?
Where the pulmonary valve leaflets are partly fused together giving restrictive exit from the right ventricle
How do most cases of pulmonary stenosis present?
They are mostly asymptomatic
How can critical pulmonary stenosis present in some neonates?
They have a duct-dependant pulmonary circulation and present with cyanosis
What are the signs of pulmonary stenosis?
- Murmur
- Ejection click
- Right ventricular heave (when severe)
Describe the murmur in pulmonary stenosis?
Ejection systolic
Where is the murmur best heard in pulmonary stenosis?
Upper left sternal edge
Where is the ejection click best heard?
Upper left sternal edge
What investigations may be used in pulmonary stenosis?
- CXR
- ECG
- Echo
What might be seen on CXR in pulmonary stenosis?
Normal or post-stenotic dilatation of the pulmonary artery
What might be seen on ECG?
Evidence of RVH (upright T wave in V1)
When is intervention required in pulmonary stenosis?
When pressure gradient across the valve is >64mmHg
What is the treatment of choice in most children for pulmonary stenosis?
Transcatheter balloon dilatation
