Pulmonary Valve Stenosis

1 What is Pulmonary Valve Stenosis?

Pulmonary valve stenosis is a heart valve disorder in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. This type of pulmonic stenosis results in the reduction of flow of blood to the lungs.

The cause of this condition differs on the age it developed, such as for adults it is a result of a complication from an underlying disease but for infant’s pulmonary valve stenosis happens during fetal development and lead to congenital heart defect after birth.

Symptoms of Pulmonary valve stenosis have varying degrees. Minor condition does not progress to a more serious symptom through time, but moderate to severe stenosis would most likely become a serious problem and may require major medical intervention.

Fortunately, it has been proven that the treatment such as surgery is highly effective in curing most people from pulmonary valve stenosis which leads to restoration of normal life.

2 Symptoms

Most people with mild pulmonary stenosis would be asymptomatic. Signs and symptoms of Pulmonary valve stenosis would normally be noticeable during the moderate to severe stage or when the extent of obstruction is already slightly advanced.

Heart murmur, which is atypical abnormal whooshing sound heard by listening to the heart that is caused by turbulent blood flow, shortness of breath, especially during exertion, chest pain, loss of consciousness (fainting) and fatigue are the common signs and symptoms of pulmonary valve stenosis.

You should right away seek medical attention once the signs and symptoms previously mentioned start to present. Early detection and treatment of the condition will decrease the risk of developing further complications.

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3 Causes

Pulmonary valve stenosis is caused by the impaired growth of pulmonary valve during fetal development. The exact cause why such abnormal develop happens is still not known.

There are also associated congenital heart abnormalities for babies with pulmonary valve stenosis. The normal anatomy of the pulmonary valve is that it has three thin pieces of tissue called leaflets that are arranged in a circle and function as a gateway to prevent backflow of blood.

Once the heart beats, the valve opens to allow blood to flow then simultaneously closes to prevent backflow into the right ventricle, the direction of blood flow once it passes the valve is into the pulmonary artery and continues to the lungs.

However, with pulmonary valve stenosis there is an impaired leaflets or may be too thick, or the leaflets may not separate from each other properly, once this happens, the valve doesn't open appropriately, limiting blood flow.

Additional contributing factors include: other medical conditions or having an artificial valve can cause the condition in older people.

Carcinoid syndrome is a condition in which there is an increase release of a chemical, serotonin, from growths called carcinoid tumors in the digestive system.

Rheumatic fever is a result or a complication that arise from a previous infection from a streptococcus bacteria, such as strep throat or scarlet fever, may injure the heart valves.

4 Making a Diagnosis

Once symptoms of pulmonary valve stenosis appear you will be referred to a cardiologist who will be able to provide expertise on the correct diagnosis and needed treatment.

To be able to maximize the time spent with the doctor and not waste any time, here are some things to know about on how you can best prepare for your appointment. Prepare a list of all the symptoms that you are experiencing including all those that you feel may not be related to the condition.

Also, have a list of all medications that you have taken or is taking including supplements, herbs, over-the-counter drugs and vitamins including the dosage.

Key personal information may also be needed such as major cause of stress and possible life altering changes.

For better management and coping with the condition, it is beneficial to understand it hence ask your doctor questions that you might find confusing or is concerned about regarding pulmonary valve stenosis, and such questions may be as follows:

  • What could have caused the condition and the symptoms experienced?
  • Are there contributing factors that lead to the condition?
  • What are the necessary tests to confirm diagnosis?
  • Is there any restriction or advanced preparations prior to the tests?
  • Is pulmonary valve stenosis a chronic condition?
  • What would you recommend as the best treatment for my child?
  • What are the possible side effects of balloon valvuloplasty or open-heart surgery?
  • How will I be able to manage the treatment of this condition with my underlying illness?
  • Is there a needed activity restrictions for my child?
  • Are there brochures or other printed material that I can take?
  • What websites do you recommend?
  • Are there available reading materials that I can take home and study?
  • What other resources would you recommend for me to better understand pulmonary valve stenosis?

As part of the doctor’s assessment, you will be asked questions such as:

  • When did you start noticing the symptoms?
  • Are the symptoms always present or are there times that they disappear?
  • Does movement or state of rest aggravate the symptoms?
  • Is there a measure that relieves the symptoms?

Since pulmonary valve stenosis is more commonly diagnosed during childhood but can still occur later on in life, it is important to have your child complete the regular check-ups as the condition normally does not present noticeable symptoms in the early stage.

During the physical exam of the doctor, if heart murmur is heard then pulmonary stenosis may be suspected which will lead to further tests.

Several diagnostic tests that may be ordered are as follows:

(a) Electrocardiogram, during this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles to detect electrical activity in your heart, which is then recorded so that the doctor can look into the electrical patterns. Also, it will show if the muscular wall of your right ventricle is thickened (ventricular hypertrophy).

(b) Echocardiography which are sound waves that bounce off your heart and produce moving images that can be viewed on monitor. This will allow evaluation of the structure of the pulmonary valve, the location and severity of the narrowing (stenosis), and right ventricle function.

(c) Other imaging tests include MRI and CT scans which are sometimes used to help with the diagnosis of pulmonary valve stenosis.

(d) Cardiac catheterization, with this procedure, a thin, flexible tube (catheter) is inserted into an artery or vein in your groin and weaves it up to your heart or blood vessels. A dye is then injected through the catheter to be able to visualize the blood vessels on X-ray. This will also measure the blood pressure in the heart chambers and blood vessels. This test is used prior to valvuloplasty, which is a procedure that can be done at the same time as cardiac catheterization.

5 Treatment

There are varying degrees in the treatment of pulmonary valve stenosis depending on classification of the symptoms presented.

Mild pulmonary stenosis does not normally need any treatment but regular check-ups are necessary to monitor the person’s condition.

In cases with severe pulmonary valve stenosis, available treatment include balloon valvuloplasty or open-heart surgery. The goal of balloon valvuloplasty is to widen the narrowed valve which will increase the blood flow. If balloon valvuloplasty is contraindicated then open-heart surgery will be recommended.

Open-heart surgery aims to repair the pulmonary valve and replaces with an artificial valve hence allowing normal blood flow. As with any surgical procedures, the risks for both including bleeding, infections and blood clots.

6 Prevention

To prevent the risk of having a child with pulmonary valve stenosis, during pregnancy you should:

  • Not drink alcohol.
  • Smoke or use illegal drugs.
  • Regular visits or prenatal to early detect a heart defect.
  • Have a healthy lifestyle.

7 Alternative and Homeopathic Remedies

There are n homeopathic remedies for pulmonary valve stenosis.

8 Lifestyle and Coping

Pulmonary valve stenosis puts you at a greater risk of having a heart attack hence early on develop and commit to a heart-healthy lifestyle.

Smoking and other tobacco use is a significant risk factor for heart disease hence right away quit smoking. If you will have difficulties quitting smoking, talk to your doctor as he will be able to recommend measures to help you quick such an available support service. Also, avoid secondhand smoke.

Choose heart-healthy foods, by focusing on low sodium, cholesterol and saturated fat diet instead increase your consumption of fruits, vegetables, fish, low-fat dairy products, whole grains, and lean meat.

Control your weight, if you already achieved your ideal weight then take measures to maintain in but if you are obese or overweight then start weight-loss program by engaging in regular exercise. You can consult your doctor before starting any exercise program to see if there are any restrictions in activity that will affect your condition.

Pregnancy mostly isn't a problem for women who have mild to moderate pulmonary valve stenosis. Although, if you have severe pulmonary valve stenosis, the risks of complications during labor and delivery are increased than those for women without the condition. Hence it might be necessary as per your doctor’s recommendation to undergo balloon valvuloplasty during pregnancy.

9 Risks and Complications

Pulmonary valve stenosis normally happens during fetal development hence the risk factors are unknown. However, there are instances wherein pulmonary valve stenosis develop later on in life and the risk factors to developing this condition at this stage include:

Mild to moderate pulmonary valve stenosis commonly doesn't lead to complications. While, for severe pulmonary stenosis it may be related with an infection since people with structural heart problems, such as pulmonary stenosis, are at a greater risk of developing bacterial infections in the inner lining of the heart (infectious endocarditis).

Also in severe pulmonary stenosis, the heart's right ventricle is forced to pump charger so that blood can reach the pulmonary artery.

Increased forced to pump blood by the right ventricle against increased pressure leads to the thickening of the muscular wall of the ventricle and the chamber within the ventricle to enlarge (right ventricular hypertrophy).

Eventually, the heart becomes firm and may weaken causing Heart failure. This results in swelling of the legs and abdomen and can cause fatigue and shortness of breath. Irregular heartbeat (arrhythmia).

People with pulmonary stenosis are more likely to have an irregular heartbeat that is easily resolved even without medical intervention. However, if the stenosis is severe, irregular heartbeats associated with pulmonary stenosis becomes life-threatening.

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