PULMONARY STENOSIS

AETIOLOGY - usually cogenital (isolated or associated with other abnormalities), occasionaly occurs in an acquired form with hypertrophic cardiomyopathy or secondary to the pericardial tumor involment in the area

CLINICAL FEATURES:

• ejection systolic murmur, loudest to the left of upper sternum, radiating towards the left shoulder, and increased on inspiratin; may be thrill, best felt when the patients leans forward and breathes out; preceded by an ejection sound; delay in right ventricular ejection may cause wide splitting of the second heart sound

• the post-stenotic dilatation in the pulmonary artery on the CXR

• ECG - right atrial and right ventricular hypertrophy

• ECHO - abnormal PV, outflow gradient

• mild and moderate isolated PS - common, does not usually progress, and does not required treatment

• severe pulmonary stenosis (resting gradient>50mmHG with a normal cardiac output) - needs treatment

Category: Cardiology Notes