Valvular disorders can arise from the pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy, located between the right ventricle (RV) and the pulmonary artery Pulmonary artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Lungs: Anatomy (PA). Valvular disorders are diagnosed by echocardiography Echocardiography Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic. Tricuspid Valve Atresia (TVA). Pulmonary stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) ( PS PS Invasive Mechanical Ventilation) is valvular narrowing causing RV outflow tract obstruction. Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship are often asymptomatic unless they have other congenital Congenital Chorioretinitis cardiac Cardiac Total Anomalous Pulmonary Venous Return (TAPVR) anomalies or severe PS PS Invasive Mechanical Ventilation. Symptoms (exertional dyspnea Dyspnea Dyspnea is the subjective sensation of breathing discomfort. Dyspnea is a normal manifestation of heavy physical or psychological exertion, but also may be caused by underlying conditions (both pulmonary and extrapulmonary). Dyspnea, chest pain Pain An unpleasant sensation induced by noxious stimuli which are detected by nerve endings of nociceptive neurons. Pain: Types and Pathways, and syncope Syncope Syncope is a short-term loss of consciousness and loss of postural stability followed by spontaneous return of consciousness to the previous neurologic baseline without the need for resuscitation. The condition is caused by transient interruption of cerebral blood flow that may be benign or related to a underlying life-threatening condition. Syncope) are due to RV failure. Severe PS PS Invasive Mechanical Ventilation is treated surgically.
Last updated: 11 Apr, 2022
Pulmonary (or pulmonic) valve:
Pulmonary stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) ( PS PS Invasive Mechanical Ventilation) | Pulmonary regurgitation Pulmonary regurgitation Backflow of blood from the pulmonary artery into the right ventricle due to imperfect closure of the pulmonary valve. Pulmonary Regurgitation (PR) | |
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Etiology | Mostly congenital Congenital Chorioretinitis | Mostly acquired |
Murmur | Systolic murmur, left upper sternal border (preceded by a systolic click that decreases with inspiration Inspiration Ventilation: Mechanics of Breathing) | Diastolic murmur, left upper sternal border, increases with inspiration Inspiration Ventilation: Mechanics of Breathing |
S2 S2 Heart Sounds | Split S2 S2 Heart Sounds with soft and delayed P2 | Split S2 S2 Heart Sounds with a loud P2 |
Echocardiographic findings | Thick and domed leaflets, with increased systolic velocity across the valve, RVH | Valvular abnormalities (depending on etiology), RV enlargement, and a regurgitant jet in the right ventricular outflow tract |
Heart valves:
The
pulmonary valve
Pulmonary valve
A valve situated at the entrance to the pulmonary trunk from the right ventricle.
Heart: Anatomy is the lower middle valve.
The pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy and its location in the heart
Image: “Internal Anatomy of the Heart Anatomy of the heart The heart is a 4-chambered muscular pump made primarily of cardiac muscle tissue. The heart is divided into 4 chambers: 2 upper chambers for receiving blood from the great vessels, known as the right and left atria, and 2 stronger lower chambers, known as the right and left ventricles, which pump blood throughout the body. Heart: Anatomy” by Philschatz. License: CC BY 4.0, edited by Lecturio.The function of the pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy
Image: “Pulmonary Valve” by Philschatz. License: CC BY 4.0, edited by Lecturio.Pulmonary stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) is the narrowing of the pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy causing:
Differentiation of the normal heart with a normal pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy and a heart with pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS)
Image: “ Pulmonary valve stenosis Pulmonary valve stenosis The pathologic narrowing of the orifice of the pulmonary valve. This lesion restricts blood outflow from the right ventricle to the pulmonary artery. When the trileaflet valve is fused into an imperforate membrane, the blockage is complete. Pulmonary Regurgitation” by LadyofHats. License: Public domain.Comparison of the normal heart and a heart with TOF: pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS), overriding aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy, RVH, VSD
Image: “ Tetralogy of Fallot Tetralogy of Fallot Tetralogy of Fallot is the most common cyanotic congenital heart disease. The disease is the confluence of 4 pathologic cardiac features: overriding aorta, ventricular septal defect, right ventricular outflow obstruction, and right ventricular hypertrophy. Tetralogy of Fallot” by LadyofHats. License: Public domain.Echocardiography. A: pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) with a maximum gradient of 126  mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg before pulmonary balloon valvuloplasty; B: mild pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) after balloon valvuloplasty (maximum gradient of 37 mm MM Multiple myeloma (MM) is a malignant condition of plasma cells (activated B lymphocytes) primarily seen in the elderly. Monoclonal proliferation of plasma cells results in cytokine-driven osteoclastic activity and excessive secretion of IgG antibodies. Multiple Myeloma Hg)
Image: “Pulmonary Balloon Valvuloplasty” by Oylumlu M, Aykent K, Soydinc HE, Oylumlu M, Ertas F, Ozer HO, Sari I. License: CC By 3.0.Cardiac magnetic resonance Cardiac magnetic resonance Aortic Regurgitation image: right ventricular outflow tract view showing foreshortened RV and a pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy with moderate-to-severe stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS). The high-velocity jet of the stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) can be seen (arrow). PA = main pulmonary artery Pulmonary artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Lungs: Anatomy.
Image: “Heart valve disease” by Myerson SG, John Radcliffe Hospital. License: CC BY 2.0Right ventricular angiogram done in postero-anterior view showing infundibular narrowing and doming pulmonary valve Pulmonary valve A valve situated at the entrance to the pulmonary trunk from the right ventricle. Heart: Anatomy
Image: “Tetralogy of fallot” by Kannan BR. License: CC BY 2.0.Chest X-ray Chest X-ray X-ray visualization of the chest and organs of the thoracic cavity. It is not restricted to visualization of the lungs. Pulmonary Function Tests of an adult woman with severe pulmonary valvular stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS). The patient underwent percutaneous pulmonary balloon valvuloplasty (PBV). Left image: A chest X-ray X-ray Penetrating electromagnetic radiation emitted when the inner orbital electrons of an atom are excited and release radiant energy. X-ray wavelengths range from 1 pm to 10 nm. Hard x-rays are the higher energy, shorter wavelength x-rays. Soft x-rays or grenz rays are less energetic and longer in wavelength. The short wavelength end of the x-ray spectrum overlaps the gamma rays wavelength range. The distinction between gamma rays and x-rays is based on their radiation source. Pulmonary Function Tests revealed marked enlargement of the main pulmonary trunk Pulmonary Trunk Truncus Arteriosus from PS PS Invasive Mechanical Ventilation. Right image: The lateral view shows a complication of the procedure, with the catheter entrapped across the fossa ovalis Fossa ovalis Prenatal and Postnatal Physiology of the Neonate.
Image: “Entrapped Catheter across the Fossa Ovalis” by Betigeri VM, Gopinathan G, Malik I, Sanwal MK, Datt V, Satsangi DK. License: CC BY 3.0.