The pulmonary valve is located between the right ventricle and the pulmonary artery. It has three cusps or leaflets or flaps (pieces of tissue arranged in a circle). The valve opens in the direction of blood flow into the pulmonary artery and then closes to prevent backward blood flow. With each heartbeat, the valve opens and then closes.
Pulmonary stenosis definition
Obstruction or deformity of the pulmonary valve (one or more cusps become defective, fused or thick) causes narrowing of the opening of the pulmonary valve – which slows blood flow. This condition is known as pulmonary stenosis. (See. Image)
People who have this condition may have symptoms that could be mild or severe. Pulmonary stenosis associated with mild symptoms continues to remain so over time without any worsening symptoms. However, stenosis associated with moderate or severe symptoms may worsen and require intervention.
The good news about pulmonary artery stenosis is that treatment is highly successful as many people can lead a happy life after the treatment. The long-term outlook after balloon valvuloplasty or surgery is excellent.
Pulmonary Valve Stenosis symptoms
- Symptoms may vary depending on the extent of obstruction.
- Mild cases of stenosis often go unnoticed as there are no symptoms.
- In severe cases, as the obstruction is significant, symptoms manifest. Initially, symptoms appear during activity or exercise.
- Shortness of breath with exertion or exercise or physical activity
- Heavy or rapid breathing
- Chest pain
- Rapid heart rate
- Weakness or fatigue
- Fainting (syncope)
- Heart murmur
Pulmonary stenosis murmur – This is the whooshing sound heard by a physician or cardiologist using a stethoscope.
What are the causes of these issues?
Pulmonary stenosis causes
- Pulmonary artery stenosis could be due to complications from other illnesses or infections such as rheumatic fever caused by streptococcus bacteria.
- In the majority of the cases, it is due to a congenital heart defect as the pulmonary valve doesn’t grow properly during fetal development.
Pulmonary stenosis complications
- Pulmonary valve opening becomes narrow.
- The risk of bacterial infection in the heart (infective endocarditis) increases in people who develop this condition.
- Ventricular hypertrophy: Thickening of the ventricular wall as the right ventricle tries harder to pump blood forcefully into the pulmonary artery. This condition leads to stiff and weakened hearts and causes pumping problems.
- Heart failure: due to inefficient pumping and problems associated with the condition, heart failure sets in. Fatigue, shortness of breath, and swelling of legs and abdomen may occur.
- Arrhythmias or Irregular Heartbeats: The risk of this condition increases significantly with the severity of stenosis.
Pulmonary Valve Stenosis diagnosis
A cardiologist evaluates a child or an adult by taking into account their symptoms and medical history. The cardiologist during physical examination puts the stethoscope on the chest to listen to the sounds of the heart and lungs. The doctor looks out for the typical heart murmur (an abnormal heart sound). Based on the symptoms and physical examination, the doctor, if suspects any abnormality, may order these tests: chest X-ray, ECG and Echo to diagnose the condition.
Pulmonary stenosis treatment
Interventional or therapeutic catheterization (balloon valvuloplasty) is a procedure in which a special catheter with a balloon is guided and directed up to the defective valve and then the balloon is inflated to stretch open the valve. Some children may need an advanced interventional procedure or surgery depending on the severity of the condition and symptoms associated with it.
Pulmonary valve stenosis may often be due to congenital heart defects in children. It could also be due to complications from another illness (rheumatic fever) in adults. Therefore, see your cardiologist if you experience or notice chest pain, shortness of breath, and fainting in your child.