Pulmonary valve stenosis echocardiogram
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Pulmonary valve stenosis |
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Differentiating Pulmonary valve stenosis from other Diseases |
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Pulmonary valve stenosis echocardiogram On the Web |
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American Roentgen Ray Society Images of Pulmonary valve stenosis echocardiogram |
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Risk calculators and risk factors for Pulmonary valve stenosis echocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Echocardiography
2D Echocardiography
- Thickened leaflets with systolic bowing in valvular stenosis.
- Difficult to distinguish between valvular, sub valvular and supra valvular stenosis with 2D echocardiography.
- Post stenotic pulmonary artery dilatation can be visualised sometimes.
Doppler Echocardiography
- Ante grade velocity increased with corresponding maximum and mean pressure gradients.
- Pulmonary valve area can be calculated using the continuity equation.
- Pulmonary Valve Area = (Cross sectional areaRVOT * VTIRVOT)/ VTIPV
- The site of obstruction can be difficult to diagnose by 2D echo. Cautious use of colour flow mapping and PW Doppler can pin point the location of obstruction.
- Pulmonic Stenosis 1
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- Pulmonic Stenosis 2
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- Pulmonic Stenosis 3
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Severity Assessment
| Severity | mild | moderate | severe |
|---|---|---|---|
| Valve area | >1.0 | 1- 0.5 | <0.5 |
| Peak gradient (mm Hg) | <10-25 | 25-40 | >40 |
2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease and Management of Patients with Valvular Heart Disease (DO NOT EDIT)[1][2]
Evaluation of the Unoperated Patient (DO NOT EDIT)[2]
| Class I |
| "1. Two-dimensional echocardiography-Doppler, chest x-ray, and ECG are recommended for the initial evaluation of patients with valvular PS. (Level of Evidence: C)" |
| "2. A follow-up physical examination, echocardiography-Doppler, and ECG are recommended at 5-year intervals in the asymptomatic patient with a peak instantaneous valvular gradient by Doppler less than 30 mm Hg. (Level of Evidence: C)" |
| "3. A follow-up echocardiography-Doppler is recommended every 2 to 5 years in the asymptomatic patient with a peak instantaneous valvular gradient by Doppler greater than 30 mm Hg. (Level of Evidence: C)" |
| Class III |
| "1. Cardiac catheterization is unnecessary for diagnosis of valvular PS and should be used only when percutaneous catheter intervention is contemplated. (Level of Evidence: C)" |
Evaluation of Pulmonic Stenosis in Adolescents and Young Adults (DO NOT EDIT)[1]
| Class I |
| "1. Transthoracic Doppler echocardiography is recommended for the initial evaluation of pulmonic stenosis in adolescent and young adult patients, and serially every 5 to 10 years for follow-up examinations. (Level of Evidence: C) " |
Sources
- 2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]
- 2008 ACC/AHA guidelines for the management of adults with congenital heart disease [2]
References
- ↑ 1.0 1.1 1.2 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 2.2 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.