pulmonary and aortic stenosis Flashcards
symptoms of pulmonary stenosis
mild - asymptomatic
moderate/severe - exertional dyspnoea and fatigue
ejection systolic murmur upper L sternal border w/ radiation to back
what determines the stages of PS
gradient in doppler flow across the valve measured on echo
interventions for PS
balloon valvoplasty
what is balloon valvoplasty
catheter placed through femoral vein
pushed up into RA through tricuspid valve up to pulmonary valve
balloon blown up which stretches the valve
what is PS usually due to
adhesions between the cusps of the valve in the periphery
- ballooning the valve is relatively uncontrolled and damage to the cusps can occur → regurgitation
how well is pulmonary regurg tolerated in children
well - low pressure situation
in older age the valve may need replaced
- uncommon in children, valve replacement is delayed until after puberty if possible
complications of pulmonary valve replacement
scar tissue can affect conduction of electrical impulses between atria and ventricles
symptoms of AS
- mostly asymptomatic
- severe - reduced exercise tolerance, exertional chest pain, syncope
- ejection systolic murmur upper R sternal border, radiation to carotids
how common is AS
2nd most common valvular problem in childhood
PS is most common
treatment of AS
balloon valvoplasty - AR is common after due to high pressure an isn’t as well tolerance
valve replacement required earlier - biosynthetic or transplant across pulmonary valve and use artificial valve in place of pulmonary