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Pulmonary Regurgitation

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Pulmonary regurgitation is a heart condition where the blood flows back into the right ventricle through the pulmonary valve, from the pulmonary valve during diastole. It is mostly asymptomatic in nature and usually diagnosed by an echocardiography. Pulmonary regurgitation is very common after a surgery for pulmonary stenosis and repair of tetralogy of Fallot.

The condition can be well tolerated during childhood and long-term chronic pulmonary regurgitation can lead to certain complications in adulthood.

What is Pulmonary Regurgitation?

During a normal heartbeat, the right ventricle (lower chamber) of the heart pushes blood through the pulmonary artery that flows into the lungs. To prevent a back flow of blood, the pulmonary valve, helps control the flow of blood from the heart to the lungs. It is present between the right ventricle and the main pulmonary artery.

However, when the valve fails to shut tightly, it allows blood to leak back into the right ventricle, before it flows back to the lungs for oxygenation.  This causes pulmonic or pulmonary insufficiency. The condition varies in severity from mild, moderate or severe.

Symptoms of Pulmonary Regurgitation

Pulmonary regurgitation remains asymptomatic in infants and children. With age, the symptoms may start making an appearance such as:

  • Fatigue
  • Problems breathing, especially after exercising or carrying out intense physical activity
  • Chest pain
  • Heart palpitations
  • Dizziness and fainting
  • Heart murmur
  • Swelling of feet or legs
  • Bluish coloration of lips or nails
  • Arrhythmia

Causes of Pulmonary Regurgitation

Some of the possible causes for pulmonary regurgitation include:

  • Rheumatic heart disease
  • Pulmonary hypertension
  • Infective endocarditis
  • Congenital absence of the pulmonary valve
  • Tetralogy of Fallot
  • Carcinoid heart disease
  • Chest trauma
  • Post-surgery for congenital heart disease repair

Diagnosis of Pulmonary Regurgitation

Pulmonary regurgitation is detected after a physical check-up of the patient. The doctor may hear a heart murmur with the help of a sthetescope. The patient may also show signs of enlarged liver, swelling of ankles or distended jugular vein in the neck.

The doctor may then recommend diagnostic tests to confirm pulmonary regurgitation, that includes:

  • Chest X-ray
  • Pulse oximetry
  • Cardiac catheterization
  • Echocardiography
  • Cardiac MRI

Treatment for Pulmonary Regurgitation

Mild cases of pulmonary regurgitation do not require any treatment. In some cases, even regular check-up is not necessary. However, moderate to severe conditions require regular monitoring and even surgery, if required.

There are no specific medications for pulmonary regurgitation. Medications, if prescribed, help the heart pump more efficiently. In severe cases, a surgery is required to repair the pulmonary valve or even replace it. The surgery for valve is called as valvuloplasty. The patients age, gender as well as overall condition is taken into consideration before surgery.

Pulmonary regurgitation in most cases is not a very serious heart problem. In severe cases, the patient may be required to be monitored regularly. Speak to your healthcare provider for more details and information.

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Written by: Saptakee sengupta
Date last updated: April 07, 2015

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