Sandbox: Pulmonary Valve regurgitation

Causes

Congenital Causes	Acquired Causes	Chronic PR	Acute PR
Quadricuspid or Bicuspid valves Hypoplasia of the valves Prolapse of the pulmonary valve	Infective endocarditis Post repair of tetralogy of Fallot Post repair of pulmonary valve stenosis Rheumatic heart disease Carinoid Syndrome Myxomatous Degeneration of the pulmonary valve.	Following repair of tetralogy of Fallot Following balloon or surgical valvulotomy or valvuloplasty for pulmonary stenosis Absent pulmonary valve syndrome Isolated congenital PR Peripheral pulmonary artery stenosis Pulmonary hypertension Right ventricular outlet aneurysm	Neonatal Ebstein’s anomaly Following balloon dilation of critical pulmonary stenosis Perforation of valvar pulmonary atresia

Physical Examination

The physical examination findings in significant pulmonary regurgitation include:

• Soft diastolic, decrescendo murmur best heard in the left upper sternal region which increases in intensity with inspiration.
• It can accompanied by a systolic ejection murmur.
• Right ventricular heave is present when the right ventricle is enlarged.