Sandbox:Pulmonary valve stenosis: Difference between revisions
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*Pulmonary valve is located at the distal part of the right ventricular outflow tract at the junction of the pulmonary artery. | *Pulmonary valve is located at the distal part of the right ventricular outflow tract at the junction of the pulmonary artery. | ||
*It is located anterior and superior to the aortic valve at the level of the third intercostal space and separated from the tricuspid valve by the infundibulum of the right ventricle. | *It is located anterior and superior to the aortic valve at the level of the third intercostal space and separated from the tricuspid valve by the infundibulum of the right ventricle. | ||
*It is comprised of three equal sized, semilunar cusps or leaflets (right, left, anterior), nomenclature based on | *It is comprised of three equal sized, semilunar cusps or leaflets (right, left, anterior), nomenclature based on the corresponding aortic valve. | ||
*The three cusps are joined by commissures and the cusps are thinner when compared to the aortic valve, due to a low pressure in the right ventricle. | *The three cusps are joined by commissures and the cusps are thinner when compared to the aortic valve, due to a low pressure in the right ventricle. | ||
*The area of the valve | *The area of the valve is related to body surface area and men usually have greater valve area when compared with women.<ref name="pmid10788818">{{cite journal| author=Capps SB, Elkins RC, Fronk DM| title=Body surface area as a predictor of aortic and pulmonary valve diameter. | journal=J Thorac Cardiovasc Surg | year= 2000 | volume= 119 | issue= 5 | pages= 975-82 | pmid=10788818 | doi=10.1016/S0022-5223(00)70092-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10788818 }} </ref> | ||
*The normal orifice area is approximately around 3cm².<ref name="pmid1428292">{{cite journal| author=Singh B, Mohan JC| title=Doppler echocardiographic determination of aortic and pulmonary valve orifice areas in normal adult subjects. | journal=Int J Cardiol | year= 1992 | volume= 37 | issue= 1 | pages= 73-8 | pmid=1428292 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1428292 }} </ref> | *The normal orifice area is approximately around 3cm².<ref name="pmid1428292">{{cite journal| author=Singh B, Mohan JC| title=Doppler echocardiographic determination of aortic and pulmonary valve orifice areas in normal adult subjects. | journal=Int J Cardiol | year= 1992 | volume= 37 | issue= 1 | pages= 73-8 | pmid=1428292 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1428292 }} </ref> | ||
*The pulmonary valve opens in the right ventricular systole allowing the | *The pulmonary valve opens in the right ventricular systole allowing the deoxygenated blood to be delivered to the lungs. | ||
*During the right ventricular diastole the pulmonary valves | *During the right ventricular diastole the pulmonary valves close completely to prevent regurgitation of blood into the right ventricle. | ||
===Pathogenesis=== | ===Pathogenesis=== | ||
Revision as of 21:33, 7 December 2016
Overview
Historical Perspective
Epidemiology and Demographics
Incidence of isolated PS is 1.5-6.5 per 10,000live births and accounts for 2 to 13% of all congenital heart lesions.
Causes
Pulmonary valve stenosis majority of times is due to a structural anomaly. Any aetiology causing changes in the valve anatomy can result in a stenotic valve. The following is the list of causes resulting in pulmonary stenosis:
- Congenital or associated with congenital heart disease: This accounts for 95% of the cases and they include:
- Tetralogy of Fallot
- Double outlet right ventricle
- Univentricular atrio-ventricular connection
- Atrioventricular canal defect
- Isolated pulmonic stenosis: Congenital malformations resulting in isolated PS include dome shaped acommissural and dysplastic valves.
- Bicuspid pulmonary valve: Frequently associated with Tetralogy of Fallot.
- Quadricuspid pulmonary valve
Pathophysiology
Anatomy
- Pulmonary valve is located at the distal part of the right ventricular outflow tract at the junction of the pulmonary artery.
- It is located anterior and superior to the aortic valve at the level of the third intercostal space and separated from the tricuspid valve by the infundibulum of the right ventricle.
- It is comprised of three equal sized, semilunar cusps or leaflets (right, left, anterior), nomenclature based on the corresponding aortic valve.
- The three cusps are joined by commissures and the cusps are thinner when compared to the aortic valve, due to a low pressure in the right ventricle.
- The area of the valve is related to body surface area and men usually have greater valve area when compared with women.[1]
- The normal orifice area is approximately around 3cm².[2]
- The pulmonary valve opens in the right ventricular systole allowing the deoxygenated blood to be delivered to the lungs.
- During the right ventricular diastole the pulmonary valves close completely to prevent regurgitation of blood into the right ventricle.
Pathogenesis
- Pulmonic valve stenosis can result from structural alterations resulting from congenital and acquired causes.
Genetics
Associated Conditions
History, Symptoms
Physical Examination
Diagnosis
Treatment
Guidelines
Medical Therapy
Surgical Therapy
Follow up
Prevention
Reflist</2> Template:WH Template:WS
- ↑ Capps SB, Elkins RC, Fronk DM (2000). "Body surface area as a predictor of aortic and pulmonary valve diameter". J Thorac Cardiovasc Surg. 119 (5): 975–82. doi:10.1016/S0022-5223(00)70092-4. PMID 10788818.
- ↑ Singh B, Mohan JC (1992). "Doppler echocardiographic determination of aortic and pulmonary valve orifice areas in normal adult subjects". Int J Cardiol. 37 (1): 73–8. PMID 1428292.