The pulmonary valve is situated between the right ventricle and the pulmonary artery. This valve functions as a gateway that allows blood to flow into and out of the heart. Pulmonary valve stenosis is a condition where the pulmonary valve narrows and does not open properly. It is a rare congenital heart defect and, in most cases, does not require any medical management. It ranges from mild and without symptoms to severe. Moderate and severe cases may worsen if left untreated and require surgery. Treatment is phenomenally successful and most people with this condition can lead normal lives.

Symptoms

Pulmonary valve stenosis affects the body’s ability to get a proper supply of oxygenated blood. Most children do not exhibit any symptoms until adulthood. Some of the common symptoms associated with pulmonary valve stenosis include:

Heart murmur

Enlarged jugular vein

Bluish colour changes in the skin

Chest pain

Fainting

Rapid Heartbeat

Fatigue

Difficulty breathing

Pulmonary valve stenosis can lead to sudden death in severe cases. Thus, it is vital to diagnose and provide proper treatment. In a few cases, symptoms may not show until stenosis becomes severe.

Also Read: Heart Valve Disease: Causes, Symptoms And Treatment

What Causes Pulmonary Valve Stenosis?

The exact cause of pulmonary valve stenosis is not known. In the foetus, the pulmonary valve may fail to develop properly during pregnancy. It may also be caused due to genetic. This condition may be associated with other heart defects. If a person is diagnosed with pulmonary valve stenosis, the health care provider may suggest taking further tests to make sure the heart is healthy and normal. Adults may also develop this condition as a complication of an illness that affects the heart such as rheumatic fever and carcinoid tumours in the gastrointestinal system.

Complications Of Pulmonary Valve Stenosis

If left untreated pulmonary stenosis can lead to several deadly complications like right ventricular hypertrophy or heart enlargement. These conditions can weaken and permanently damage the heart. It may also cause the heart to beat irregularly. Improper blood flow to the tissues can lead to cyanosis, which causes the skin to turn blue and affects breathing. Any structural impairment in the heart can elevate the risk of an infection inside the heart. In the long run, the extra effort that heart had to exert may lead to heart failure and death.

Diagnosis

Pulmonary valve stenosis generally causes a heart murmur. A heart murmur usually sounds like an extra click, blowing, whooshing or rasping sound when the doctor examines the heart. The murmur can be an initial indicator of this condition and may also suggest further testing. The doctor may recommend certain imaging tests to visualize the heart’s anatomy and examine if the blood is flowing freely or if there is any narrowing of the pulmonary valve.

Chest X-ray

Electrocardiogram (EKG)

Echocardiogram

MRI scan

Treatment

The doctors upon examining the imaging scans and other tests suggest the best mode of treatment for pulmonary stenosis. Mild stenosis without any symptoms does not require any interventions.

Seek prompt medical care if you experience chest pain, shortness of breath or fainting. These symptoms may indicate that the condition is progressing. The doctor may also prescribe certain medications to improve the blood flow through the heart’s chamber.

Prostaglandins to promote blood flow

Blood thinners to lower clotting

Medications to reduce fluid build-up in the bloodstream

Drugs to prevent irregular heart rhythms

Depending on the degree of narrowing, more severe cases may need a balloon valvuloplasty or open-heart surgery.

A surgical procedure known as balloon valvuloplasty helps to stretch the pulmonary valve’s wall to enhance proper blood circulation. This procedure involves inserting a catheter that has a balloon at one end that inflates and expand the heart’s valve.

In open-heart surgery, the doctor may repair the pulmonary valve or replace the valve with an artificial valve- a mechanical or biological valve made from cow or pig valves. There is a mild risk of bleeding, infection or blood clots associated with the surgery.