Pulmonary valve stenosis

Question 1

What is the role of the pulmonary valve?

Answer 1

deoxygenated blood flows from right ventricle to the lungs and the valve stops potential back flow to the heart

Question 2

What can congenital pulmonary valve stenosis be associated with?

Answer 2

Tetralogy of Fallot
William syndrome
Noonan syndrome
Congenital rubella syndrome

Question 3

How does pulmonary valve stenosis present?

Answer 3

often asymptomatic
in severe cases can be fatigue, exertion, shortness of breath and dizziness

Question 4

What are the signs on examination of pulmonary valve stenosis?

Answer 4

Ejection systolic murmur heard loudest at the pulmonary area (second intercostal space, left sternal border)
Palpable thrill in the pulmonary area
Right ventricular heave due to right ventricular hypertrophy
Raised JVP with giant a waves

Question 5

How do we manage pulmonary valve stenosis?

Answer 5

The gold standard investigation for establishing a diagnosis is an echocardiogram.

In mild pulmonary stenosis without symptoms patients do not require any intervention.

If the patient is symptomatic or the valve is more significantly stenosed, balloon valvuloplasty via a venous catheter is the treatment of choice.