pulmonary and aortic stenosis

Question 1

symptoms of pulmonary stenosis

Answer 1

mild - asymptomatic

moderate/severe - exertional dyspnoea and fatigue

ejection systolic murmur upper L sternal border w/ radiation to back

Question 2

what determines the stages of PS

Answer 2

gradient in doppler flow across the valve measured on echo

Question 3

interventions for PS

Answer 3

balloon valvoplasty

Question 4

what is balloon valvoplasty

Answer 4

catheter placed through femoral vein

pushed up into RA through tricuspid valve up to pulmonary valve

balloon blown up which stretches the valve

Question 5

what is PS usually due to

Answer 5

adhesions between the cusps of the valve in the periphery

• ballooning the valve is relatively uncontrolled and damage to the cusps can occur → regurgitation

Question 6

how well is pulmonary regurg tolerated in children

Answer 6

well - low pressure situation

in older age the valve may need replaced

• uncommon in children, valve replacement is delayed until after puberty if possible

Question 7

complications of pulmonary valve replacement

Answer 7

scar tissue can affect conduction of electrical impulses between atria and ventricles

Question 8

symptoms of AS

Answer 8

• mostly asymptomatic
• severe - reduced exercise tolerance, exertional chest pain, syncope
• ejection systolic murmur upper R sternal border, radiation to carotids

Question 9

how common is AS

Answer 9

2nd most common valvular problem in childhood

PS is most common

Question 10

treatment of AS

Answer 10

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