The narrowing of the pulmonary valve forces the right ventricle to pump harder, damaging the heart muscle.

Pulmonary valve stenosis is a narrowing of the pulmonary valve that slows blood flow from the heart to the lungs. It is a common heart defect. The heart’s pulmonary valve opens to allow blood to flow from the right ventricle to the lungs. When the pulmonary valve narrows (stenosis), this ventricle has to pump harder, which can cause higher pressure in the right ventricle. This can damage the heart muscle over time and contribute to heart failure.

Causes of pulmonary valve stenosis

Pulmonary valve stenosis is usually a congenital heart defect, and the exact cause is not known. Mothers who have rubella (German measles) during pregnancy are more likely to have babies who have pulmonary valve stenosis and other heart defects. Rheumatic fever, a complication of strep throat infection, also can cause pulmonary valve stenosis.

Symptoms of pulmonary valve stenosis

Mild cases of pulmonary valve stenosis often cause no symptoms. More severe cases cause symptoms including:

  • Heart murmur (an abnormal whooshing sound heard using a stethoscope, caused by the blood not flowing smoothly)
  • Shortness of breath, especially during exertion
  • Chest pain
  • Loss of consciousness (fainting)
  • Fatigue

How Ohio State diagnoses pulmonary valve stenosis

Pulmonary valve stenosis is often diagnosed when a physician hears an abnormal sound, such as a heart murmur, through a stethoscope during a routine examination. In many cases, the condition is diagnosed during childhood.

Tests to confirm a diagnosis of pulmonary valve stenosis include:

Echocardiogram (also called echo) – This test uses sound waves to assess the function and structure of the heart muscle and valves.

Electrocardiogram (EKG/ECG) – A test that records the electrical activity of the heart.

Cardiac catheterization – A procedure to check for problems in coronary arteries. A long, thin tube (catheter) is inserted into an artery or vein in the groin, arm or neck, then threaded to the heart. The physician injects a contrast solution into the artery and takes X-rays to check for blockage and other abnormalities.

Cardiac MRI (cardiac magnetic resonance imaging or CMR) – A noninvasive, sophisticated imaging procedure that uses large magnets and a computer to produce detailed images of the structure and function of the heart while it is beating.

CT heart scan – An imaging procedure that uses a type of X-ray that provides cross-sectional images of the body. It offers highly detailed information to study blood flow through the heart arteries and vessels to identify where blockages exist.

How Ohio State treats pulmonary valve stenosis

Most people who have mild pulmonary valve stenosis do not need treatment. All cases should be regularly monitored to ensure the condition does not become serious. A stenotic pulmonary valve cannot be made normal, but the obstruction can be improved.

Surgery and Procedures

Balloon valvuloplasty can often alleviate the obstruction. Open heart surgery may be necessary in other cases.

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