When the valve between the heart and lungs is narrowed, blood flow slows. Know the symptoms of this type of valve disease and how it's treated.
Pulmonary valve stenosis is a narrowing of the valve located between the lower right heart chamber (right ventricle) and the lung arteries (pulmonary arteries). In a narrowed heart valve, the valve flaps (cusps) may become thick or stiff. This reduces blood flow through the valve.
Usually, pulmonary valve disease results from a heart problem that develops before birth (congenital heart defect). However, adults may develop pulmonary valve stenosis as a complication of another illness.
Pulmonary valve stenosis ranges from mild to severe. Some people with mild pulmonary valve stenosis don't notice any symptoms and may only require occasional doctor's checkups. Moderate and severe pulmonary valve stenosis may require a procedure to repair or replace the valve.
Pulmonary valve stenosis signs and symptoms vary, depending on how much blood flow is blocked. Some people with mild pulmonary stenosis don't have symptoms. Those with more-severe pulmonary stenosis may first notice symptoms while exercising.
Pulmonary valve stenosis signs and symptoms may include:
Babies with pulmonary valve stenosis and other congenital heart defects may appear blue (cyanotic).
Talk to your doctor if you or your child has:
If you or your child has pulmonary stenosis or another heart problem, prompt diagnosis and treatment can help reduce the risk of complications.
Pulmonary valve stenosis is most often a congenital heart defect. The exact cause is unclear. The pulmonary valve doesn't develop properly as the baby is growing in the womb.
The pulmonary valve is made of three thin pieces of tissue called flaps (cusps). The cusps open and close with each heartbeat and make sure blood moves in the right direction.
In pulmonary valve stenosis, one or more of the cusps may be stiff or thick, or the cusps may be joined (fused) together. As a result, the valve doesn't open fully. The smaller valve opening makes it harder for blood to flow out of the lower right heart chamber (right ventricle). Pressure increases inside the right ventricle as it tries to push blood through the smaller opening. The increased pressure creates a strain on the heart that eventually causes the right ventricle's muscular wall to thicken.
Conditions or disorders that may increase the risk of pulmonary valve stenosis include:
Possible complications of pulmonary stenosis include:
Pulmonary valve stenosis is often diagnosed in childhood. However, it may not be detected until later in life.
The doctor will use a stethoscope to listen to your or your child's heart. A whooshing sound (murmur) caused by choppy (turbulent) blood flow across the narrowed valve may be heard.
Tests to diagnose pulmonary valve stenosis may include:
Cardiac catheterization. A thin tube (catheter) is inserted into the groin and threaded through the blood vessels to the heart. Dye can be injected through the catheter into the blood vessels to make them more visible on X-rays (coronary angiogram).
Doctors also use cardiac catheterization to measure pressure within the chambers of the heart to see how forcefully blood pumps through the heart. If you've been diagnosed with pulmonary valve stenosis, your doctor can determine how severe the condition is by comparing the difference in blood pressure between the right lower heart chamber and the pulmonary artery.
If you have mild pulmonary valve stenosis without symptoms, you may only need occasional doctor's checkups.
If you have moderate or severe pulmonary valve stenosis, you may need a heart procedure or heart surgery. The type of procedure or surgery you have depends on your overall health and the appearance of your pulmonary valve.
Heart procedures and surgery used to treat pulmonary valve stenosis include:
Balloon valvuloplasty. The doctor inserts a flexible tube (catheter) with a balloon on the tip into an artery, usually in the groin. X-rays are used to help guide the catheter to the narrowed valve in the heart. The doctor inflates the balloon, which widens the valve opening, and separates the valve flaps, if needed. The balloon is then deflated. The catheter and balloon are removed.
Valvuloplasty may improve blood flow through the heart and reduce pulmonary valve stenosis symptoms. However, the valve may narrow again. Some people need valve repair or replacement in the future.
Pulmonary valve replacement. If balloon valvuloplasty isn't an option, open-heart surgery or a catheter procedure may be done to replace the pulmonary valve. If there are other congenital heart defects, the doctor can often repair those during the same surgery.
People who have had pulmonary valve replacement need to take antibiotics before certain dental procedures or surgeries to prevent endocarditis.
If you have valve disease, it's important to take steps to keep your heart healthy. Certain lifestyle changes can decrease your risk of developing other types of heart disease or having a heart attack.
Lifestyle changes to talk to your doctor about include:
If you or your child has valve disease, you will be referred to a doctor trained in evaluating and treating heart conditions (cardiologist).
Here's some information to help you get ready for your appointment.
Preparing a list of questions can help you make the most of your time with your doctor. For pulmonary valve stenosis, some basic questions include:
Don't hesitate to ask other questions.
Your doctor is likely to ask you a number of questions, including:
August 26th, 2021