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Pulmonary Stenosis

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The pulmonary valve, also called as pulmonic valve is located between the right ventricle and the main pulmonary artery. The pulmonary valve prevents the backflow of the blood from the artery into the heart between heart beats. When this mechanism fails, it leads to pulmonary stenosis.

What is Pulmonary Stenosis?

The pulmonary valve between the right ventricle and the pulmonary artery is made up of three thin flaps or leaflets. When either two of the leaflets get stuck together or too thick or develop certain deformity, it leads to pulmonary stenosis.

In some cases, there may be fewer than three leaflets of the pulmonary heart. These defects are usually congenital in nature. The condition can either be mild, moderate, severe and even life-threatening.

Pulmonary stenosis is a part of almost half of all complex congenital heart defects. About 5 to 10% of all cases of congenital heart defects consistsof isolated pulmonary stenosis.

Types of Pulmonary Stenosis

There are three types of pulmonary stenosis:

  • Valvar pulmonary stenosis: The condition where the leaflets are thickened or get narrow causing blood flow obstruction.
  • Supravalvar pulmonary stenosis: The area of the pulmonary artery located just above the pulmonary valve gets narrowed.
  • Subvalvar pulmonary stenosis: When the muscles under the valve get thickened or narrowed that causes problems with the outflow of the blood from the right ventricle.
  • Branch peripheral pulmonic stenosis: The narrowing of the right or left pulmonary artery or both get narrowed.

Causes of Pulmonary Stenosis

Pulmonary stenosis is a congenital heart defect that is usually inborn. It occurs due to improper development of the pulmonary valve in the fetus that is about 8 weeks old. One or more leaflets may be too thick or defective. In some cases, the leaflets fuse together restricting blood flow. It can either have a genetic link for the development of the defect. Or in some cases, there is no clear reason for the heart defect and can occur by chance.

Symptoms of Pulmonary Stenosis

In some cases, pulmonary stenosis does not lead to any symptoms. When the right ventricle has to work harder to pump blood out through the tight pulmonary valve, it leads to a buildup of pressure in the right atrium. This causes backflow of the blood into the right side of the heart. Thus, leading to fluid retention and swelling. Some of the most common symptoms of pulmonary stenosis are:

  • Shortness of breath
  • Heavy or rapid breathing
  • Fatigue
  • Rapid heart rate
  • Swelling of the face, eyelids, abdomen, ankles and feet
  • Heart murmur
  • Chest pain
  • Loss of consciousness

Diagnosis of Pulmonary Stenosis

Pulmonary stenosis is often detected in childhood when the child experiences fainting spells, fatigue, swelling, etc. In many cases, the case is detected much later in life. During a routine checkup, the doctor may pick up a heart murmur and suspect pulmonary stenosis. Some of the diagnostic tests that help confirm pulmonary stenosis include:

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  • Electrocardiogram
  • Echocardiography
  • Cardiac catheterization
  • MRI or CT scan

Treatment for Pulmonary Stenosis

Treatment for pulmonary stenosis depends on the child’s age, medical history, severity of the condition (mild, moderate or severe), tolerance of the child for certain medications, procedures as well as therapies, etc.

The mild condition usually does not require any treatment. Moderate or severe stenosis is often treated with the repair of the problematic valve. Other methods of treatment include:

  • Balloon dilation or valvuloplasty
  • Valvectomy
  • Patch enlargement
  • Pulmonary valve replacement

After the procedure, the child may require care in the hospital as well as at home. Discuss with the cardiologist regarding the aftercare process for your child.

The cardiologist may prescribe antibiotics to prevent bacterial endocarditis after the surgery. During adolescence or early adulthood, the child may have to undergo replacement of the pulmonary valve. This can help prevent complications such as enlargement of the right ventricle and arrhythmias. The child will require cardiac care all through life in case of pulmonary stenosis. Thus, make sure you speak to an experienced cardiologist for your child.

Written by: healthplus24.com team

Date last updated: January 20, 2015

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