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Pulmonary valve stenosis : Causes, Types, Symptoms, Diagnosis and Treatment

 What is Pulmonary valve stenosis?

Pulmonary artery stricture could be a narrowing (stenosis) that happens within the arterial blood vessel, an outsized artery that sends element-poor blood into the lungs to be enriched with oxygen. The narrowing could occur within the main arterial blood vessel and/or within the left or right arterial blood vessel branches. This narrowing makes it troublesome for blood to succeed in the lungs to choose an element. while not enough elements, the guts and body cannot operate as they must. In an attempt to beat the narrowing, the pressure within the ventricle (the chamber that pumps blood into the pulmonary arteries) rises to levels that may be damaging to the guts muscle.

Pulmonary stenosis (also known as respiratory organ stenosis) is once the semilunar valve (the valve between the correct ventricle and also the pulmonary artery) is simply too little, narrow, or stiff.


What is Pulmonary valve stenosis



Explanation of medical terms and concepts Pulmonary valve stenosis

Pulmonary valve pathology may be a narrowing of the valve situated between the lower right heart chamber (right ventricle) and therefore the respiratory organ arteries (pulmonary arteries). in a very narrowed heart valve, the valve flaps (cusps) could become thick or stiff. This reduces blood flow through the valve.

Usually, semilunar valve sickness results from a heart downside that develops before birth (congenital heart defect). However, adults could develop semilunar valve pathology as a complication of another sickness.

Pulmonary valve pathology ranges from delicate to severe. Some folks with delicate semilunar valve pathology do not notice any symptoms and should solely need occasional doctor's checkups. Moderate and severe semilunar valve pathology could need a procedure to repair or replace the valve.

Pulmonary valve stenosis is a condition where the opening of the pulmonary valve is too small which restricts blood flow to the lungs About 70 percent of pulmonary valve stenosis patients develop right-sided heart failure and symptoms can vary significantly between patients Symptoms may include: a rapid heartbeat (tachycardia) breathlessness (dyspnea) caused by physical exertion that usually disappears when rest is taken chest pain or discomfort caused by reduced blood flow through an overworked heart muscle while exercising or due to an enlarged heart; these symptoms are often worse with exercise than at rest and can make

Pulmonary valve stenosis is a narrowing of the pulmonary valve The pulmonary valve lets blood flow from the heart's right ventricle to the lungs When it doesn't open properly blood can back up into your heart and cause symptoms such as shortness of breath and fatigue Pulmonary valve stenosis usually occurs in children with congenital heart defects especially those involving the mitral or tricuspid valves While still rare pulmonary valve stenosis also affects adults — typically middle-aged men and women who have had rheumatic fever during childhood.

Symptoms Pulmonary valve stenosis

Pulmonary valve pathology signs and symptoms vary, looking at what quantity blood flow is blocked. Some folks with gentle stenosis haven't got symptoms. Those with more-severe stenosis might initially notice symptoms whereas physical exertion.

Pulmonary valve pathology signs and symptoms might include:

  • A whooshing sound (murmur) that can be heard with a stethoscope

  • Fatigue

  • Shortness of breath, especially during activity

  • Chest pain

  • Loss of consciousness (fainting)

Babies with pulmonary valve stenosis and other congenital heart defects may appear blue (cyanotic).

When to see a doctor

Talk to your doctor if you or your child has:

  • Shortness of breath

  • Chest pain

  • Fainting

If you or your child has pulmonary stenosis or another heart problem, prompt diagnosis and treatment can help reduce the risk of complications.

Causes Pulmonary valve stenosis

Pulmonary valve structure is most frequently a non inheritable heart defect. The precise cause is unclear. The semilunar valve does not develop properly because the baby is growing within the female internal reproductive organ.

The semilunar valve is formed of 3 skinny items of tissue known as flaps (cusps). The cusps open and shut with every heartbeat and make certain blood moves within the right direction.

In semilunar valve stricture, one or a lot of the cusps could also be stiff or thick, or the cusps could also be joined (fused) along. As a result, the valve does not open totally. The smaller valve gap makes it more durable for blood to emanate from the lower right heart chamber (right ventricle). Pressure will increase within the proper ventricle because it tries to push blood through the smaller gap. The accrued pressure creates a strain on the center that eventually causes the proper ventricle's muscular wall to thicken.

Pulmonary artery structure could be a non inheritable heart defect, which means it's a defect that's inborn or exists at birth. declared differently, the defect is AN abnormality, not a malady. artery structure is commonly gift together with different non inheritable heart defects, such as:

Tetralogy of MD – a four-pronged defect consisting of: 1) a cavum congenital heart defect, 2) a narrowing at or simply to a lower place the semilunar valve, 3) a ventricle that's a lot of muscular than traditional, 4) AN artery that lies directly over the cavum congenital heart defect

Pulmonary abnormal condition – absence of a semilunar valve, preventing blood from flowing from the proper ventricle into the artery and onward to the lungs

Truncus arteriosus – the formation of just one combined artery rather than the traditional 2 shops from the center, the artery and artery

Pulmonary valve stricture – issues with the semilunar valve (for example, development of but 3 leaflets, leaflets that will be partly consolidated along, thick leaflets that don't open all the way) that create it tougher for the valve leaflets to open and allow blood to be due the proper ventricle to the lungs

Patent blood vessel – AN open passageway between the artery and therefore the artery. Normally, this passageway closes on its own at intervals many hours of birth, however once it doesn't, surgery or AN patient catheter-based procedure is required to shut the gap

Other causes of artery stricture will include: different syndromes that {affect|have AN effect on} the center (such as measles syndrome [a cluster of heart and different health issues in an baby caused by measles infection within the mother throughout pregnancy] and Williams syndrome [a cluster of abnormalities poignant the center and different organs]) and surgical procedures want to correct different heart defects (for example, artery band - a purposeful narrowing of the artery to cut back blood flow to the lungs).

Risk factors Pulmonary valve stenosis

Conditions or disorders that may increase the risk of pulmonary valve stenosis include:

  • German measles (rubella). Having German measles (rubella) during pregnancy increases the risk of pulmonary valve stenosis in the baby.

  • Noonan syndrome. This genetic disorder causes various problems with the heart's structure and function.

  • Rheumatic fever. This complication of infection will cause permanent harm to the center, as well as the center valves. It will increase the danger of developing semilunar valve pathology later in life. 

  • Carcinoid syndrome. A rare cancerous growth releases bound chemicals into the blood, inflicting shortness of breath, flushing and different signs and symptoms. Some individuals with this syndrome develop a tumor heart condition that damages heart valves. 

Complications

Possible complications of pulmonary stenosis include:

  • Infection of the lining of the heart (infective endocarditis). People with heart valve issues, like stricture, have an associated degree of exaggerated risk of developing microorganism infections that have an effect on the inner lining of the guts. 

  • Irregular heartbeat (arrhythmia). People with pulmonary stenosis are more likely to have an irregular heartbeat. Unless the stenosis is severe, irregular heartbeats due to pulmonary stenosis usually aren't life-threatening.

  • Thickening of the heart muscle. In severe stenosis, the heart's ventricle should pump more durably to force blood into the arteria pulmonalis. The strain on the center causes the muscular wall of the ventricle to thicken (right cavity hypertrophy). 

  • Heart failure. If the right ventricle can't pump properly, heart failure eventually develops. Symptoms of heart failure include fatigue, shortness of breath, and swelling of the legs and abdomen.

  • Pregnancy complications. The risks of complications throughout labor and delivery are higher for those with severe semilunar valve stricture than those while not the condition. 

Diagnosis Pulmonary valve stenosis

During a routine examination, your child’s doctor might hear abnormal heart sounds (a murmur) once taking note of the center. If abnormal sounds are known.

An graphical record (ECG or EKG) – a take a look at that records the electrical changes that occur throughout a heartbeat; reveals abnormal heart rhythms (arrhythmias) and detects muscular tissue stress.

Chest X-ray – take a look at to point out the dimensions and form of the center and lungs and pneumonic arteries.

An sonogram – a take a look at that uses sound waves to make a picture show of the heart’s internal structures.

Doppler ultrasound – a take a look at that uses sound waves to live blood flow; typically combined with sonogram to judge each the inner structure of the center and blood flow across the heart’s valves and vessels.

Cardiac resonance imaging (MRI) – a take a look at that uses three-dimensional imaging to reveal however blood flows through the center and vessels and the way the center is functioning.

CT scan – associate degree x-ray procedure that mixes several x-ray pictures with the help of a laptop to get cross-sectional views of the center. viscus CT uses the advanced CT technology with blood vessel (IV) distinction (dye) to ascertain viscus anatomy, coronary circulation, and nice vessels.

Cardiac catheterization – a procedure that involves inserting a skinny tube (a catheter) into a vein or artery and spending it into the center to sample the amount of chemical element, live pressure changes, and create x-ray movies of the center and its internal structures.

Pulmonary X-ray photography – a dye-enhanced x-ray of the pneumonic arteries and veins of the center.

Perfusion scan – take a look at within which the patient is injected with a little quantity of a material. A special machine shows however well blood is flowing through every of the 2 lungs.

Pulmonary valve stricture is usually diagnosed in childhood. However, it's going to not be detected till later in life.

The doctor can use a medical instrument to concentrate on your or your child's heart. A whooshing sound (murmur) caused by stormy (turbulent) blood flow across the narrowed valve could also be detected.

Tests to diagnose semilunar valve stricture could include:

  • Electrocardiogram (ECG or EKG). This fast and painless check records the electrical signals within the heart. Sticky patches (electrodes) are units placed on the chest and typically the arms and legs. Wires connect the electrodes to a pc that displays the check results. associate degree graph will show however the center is thrashing and will reveal signs of muscle thickening. 

  • Echocardiogram. An echocardiogram uses sound waves to produce images of the heart. This common test allows a doctor to see how the heart beats and pumps blood. An echocardiogram can show the structure of the pulmonary valve and the location and severity of any valve narrowing.

  • Cardiac catheterization. A thin tube (catheter) is inserted into the groin and rib through the blood vessels to the guts. Dye will be injected through the tube into the blood vessels to form them additional visible on X-rays (coronary angiogram).
    Doctors conjointly use viscus catheterization to lift pressure among the chambers of the guts to ascertain however forcefully blood pumps through the guts. If you have been diagnosed with semilunar valve stricture, your doctor will confirm however severe the condition is by scrutiny the distinction in pressure between the correct lower heart chamber and therefore the artery. 

  • Other imaging tests. Magnetic resonance imaging (MRI) and computed tomography (CT) scans are sometimes used to confirm the diagnosis of pulmonary valve stenosis.

Treatment Pulmonary valve stenosis

If your kid is diagnosed with artery stricture, your podiatrist or medical care doctor can advocate that you simply meet with a inborn cardiologist (a doctor World Health Organization has the coaching and instrumentation to work out your child’s heart drawback and order the mandatory special tests, medical aid, surgical operation, and follow-up checkups). The most effective treatment approach can depend upon your child’s symptoms also as different characteristics of the stricture.

If you've got delicate semilunar valve stricture while not having symptoms, you will solely want occasional doctor's checkups.

If you've got moderate or severe semilunar valve stricture, you will want a heart procedure or surgical operation. The sort of procedure or surgery you've got depends on your overall health and therefore the look of your semilunar valve.

Heart procedures and surgery want to treat semilunar valve structure include:

  • Balloon valvuloplasty. The doctor inserts a versatile tube (catheter) with a balloon on the tip into the associated artery, typically within the groin. X-rays are accustomed to facilitate the tubing to the narrowed valve within the heart. The doctor inflates the balloon, that widens the valve gap, and separates the valve flaps, if needed. The balloon is then deflated. The tubing and balloon are removed.
    Valvuloplasty might improve blood flow through the center and scale back semilunar valve pathology symptoms. However, the valve might slim once more. Some individuals want valve repair or replacement within the future. 

  • Pulmonary valve replacement. If balloon valvuloplasty is not an Associate in Nursing possibility, heart surgery or a tubing procedure is also done to switch the semilunar valve. If there are unit different non heritable heart defects, the doctor will usually repair those throughout constant surgery.
    People who have had semilunar valve replacement have to be compelled to take antibiotics before certain dental procedures or surgeries to forestall carditis. 

Lifestyle and home remedies

If you have valve disease, it's important to take steps to keep your heart healthy. Certain lifestyle changes can decrease your risk of developing other types of heart disease or having a heart attack.

Lifestyle changes to talk to your doctor about include:

  • Quitting smoking

  • Eating a heart-healthy diet that includes fruits and vegetables, low-fat dairy products, whole grains, and lean meat

  • Maintaining a healthy weight

  • Getting regular exercise

Preparing for your appointment

If you or your child has valve disease, you will be referred to a doctor trained in evaluating and treating heart conditions (cardiologist).

Here's some information to help you get ready for your appointment.

What you can do

  • Write down symptoms you or your child has, including any that may seem unrelated to the reason for which you scheduled the appointment.

  • Write down key personal information, including major stresses or recent illnesses.

  • List all medications, vitamins and supplements you or your child takes.

  • Write down questions to ask the doctor.

Preparing a list of questions can help you make the most of your time with your doctor. For pulmonary valve stenosis, some basic questions include:

  • What's the most likely cause of my or my child's symptoms?

  • Are there other possible causes?

  • What tests are needed? Do these tests require any special preparation?

  • Is pulmonary valve stenosis temporary or long lasting?

  • What treatments are available, and which do you recommend?

  • What are the risks of a balloon valvuloplasty or open-heart surgery?

  • Do I need to restrict my or my child's activity?

  • Are there brochures or other printed material that I can take? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • When did symptoms begin?

  • Do the symptoms come and go, or are they continuous?

  • Do the symptoms get worse during activity or when lying down?

  • Does anything seem to improve symptoms?

General summary

Pulmonary stenosis is treated with several medications including diuretics and digoxin These drugs reduce the body’s water retention and increase the heart rate As a result pulmonary stenosis symptoms are alleviated for many people According to the National Heart Lung and Blood Institute people who have pulmonary stenosis as a complication of congenital heart disease often take nitroglycerine tablets every day or use an infusion pump that delivers nitric oxide directly into their bloodstream through a needle inserted in their skin The drug widens blood vessels in the lungs and decreases resistance to flow

Can pulmonary valve stenosis go away?

Pulmonary valve stenosis cannot correct itself but there are treatments that can reduce or eliminate obstruction to blood flow through the pulmonary valve The most common treatment is a procedure called balloon valvuloplasty which involves inflating a small balloon inside the pulmonary valve in order to open it

Is pulmonary stenosis life threatening?

Patients with pulmonic stenosis are in danger because the condition can hamper their ability to breathe which interferes with many aspects of daily life and presents a dangerous threat So it is important for patients to schedule regular heart checkups and take medications as prescribed Talking to your doctor or cardiologist about how pulmonary stenosis affects you personally will help you control your symptoms and live an active life

Does pulmonary stenosis require surgery?

Is surgery always required to treat pulmonary valve stenosis? In many cases the answer is no If a newborn has only mild stenosis and doesn't have other associated problems it might be possible to correct the condition with medication or a catheter On the other hand if your child has moderate or severe pulmonary valve stenosis and an abnormal heart murmur in addition to left-to-right shunting across the atrial septum he's likely to benefit from open-heart surgery

Can pulmonary valve stenosis get worse?

Pulmonary valve stenosis is a condition in which the pulmonary valve between the right atrium and right ventricle becomes too narrow It can cause blood to back up into the lungs when they are not completely inflated which may reduce their ability to move oxygen from inhaled air throughout the body Pulmonary valve stenosis can also lead to heart failure due to reduced blood flow through the valve as well as arrhythmias caused by an abnormal heart rhythm

Is pulmonary stenosis considered heart disease?

Pulmonary stenosis occurs when the pulmonary artery narrows reducing blood flow through the lungs This condition is common in premature infants who often have other heart defects and respiratory problems because their underdeveloped lungs are not fully capable of getting oxygen to the body Pulmonary stenosis can also be caused by atherosclerosis or scarring of the arteries from smoking or high cholesterol levels People with this condition have been shown to develop sleep apnea which causes breathing to stop for short periods of time during sleep The symptoms of pulmonary stenosis include chest pains and abnormal heartbeat both during exercise and at rest It may also cause

Can you live without your pulmonary valve?

The pulmonary valve is a one way flap between the right ventricle and the pulmonary artery It is essential to blood circulation because it prevents regurgitation of blood into the right ventricle during systole If it were not there the heart would have to pump against a pressure gradient A replacement for this valve is a homograft usually from an animal or cadaveric donor

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Pulmonary valve stenosis : Causes, Types, Symptoms, Diagnosis and Treatment

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