Pulmonary Valve And Stenosis

Pulmonary stenosis is a rare condition characterized by narrowing of the pulmonary valve. Narrowing may occur above and below the level of the pulmonary valve as well. Here are some of the causes - 

Part of congenital syndromes

  • Noonan’s syndrome
  • Tetralogy of Fallot
  • Rubella

Acquired

  • Rheumatic fever
  • Carcinoid syndrome

Subvalvular pulmonary stenosis may be associated with

  • Ventricular septal defect
  • Tetralogy of Fallot
  • Transposition of great arteries

Pulmonary stenosis is graded as follows1


Mild
Moderate
Severe
Valve area (cm2)
>1
0.5 - 1
< 0.5
Peak gradient (mmHg)
< 36
36 - 64
> 64
Peak velocity (m/s)
<3
3 - 4
> 4

As with any valvular lesion, the continuity equation is used to measure valve area.

1. Bonow RO, Carabello BA, Chatterjee K, de Leon CC Jr, Faxon DP, Freed MD, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing Committee to Revise the 1998 guidelines for the management of patients with valvular heart disease) developed in collaboration with the Society of Cardiovascular Anesthesiologists endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. J Am Coll Cardiol 2006;48:e1-148.

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