Pulmonary Valve Stenosis

Diagnosis

Pulmonary valve stenosis is often identified during childhood, but some people may not learn they have the condition until adulthood. A healthcare provider typically listens to the heart with a stethoscope. A whooshing sound, known as a heart murmur, may be heard due to uneven blood flow across the narrowed pulmonary valve.

Several tests help confirm the diagnosis and determine how severe the narrowing is.

Electrocardiogram (ECG or EKG)
This quick, painless test records the heart’s electrical activity. Sticky patches called electrodes are placed on the chest and sometimes on the arms and legs. The test can show heart rhythm patterns and signs that the heart muscle is working harder than usual.

Echocardiogram
An echocardiogram uses sound waves to create detailed images of the heart. It shows how the heart pumps blood and can clearly reveal the structure of the pulmonary valve. This test identifies how narrow the valve is and how much it affects blood flow.

Cardiac catheterization
During this test, a thin tube called a catheter is inserted into a blood vessel, usually in the groin, and guided to the heart. Dye flowing through the catheter makes blood vessels visible on X-ray images. Pressures inside the heart are measured to determine how forcefully blood passes through the narrowed valve. The difference in pressure between the right ventricle and the lung artery helps determine stenosis severity.

Other imaging tests
MRI and CT scans may be used to confirm pulmonary valve stenosis or provide more detail about the heart and blood vessels.

Treatment

People with mild pulmonary valve stenosis and no symptoms may only need regular checkups. When stenosis is moderate or severe, a procedure or surgery may be recommended. The best treatment depends on overall health and how the pulmonary valve looks on imaging tests.

Surgeries or other procedures may be used to widen the valve opening or replace the valve if needed.

Balloon valvuloplasty
In this procedure, a flexible tube with a balloon on the tip is inserted into an artery, usually in the groin, and guided to the narrowed valve. The balloon is inflated to stretch the valve open and improve blood flow. The balloon is then deflated and removed. While this treatment often relieves symptoms, the valve may narrow again over time, requiring additional treatment.

Pulmonary valve replacement
If balloon valvuloplasty is not suitable, the pulmonary valve may need to be replaced through open-heart surgery or a catheter-based procedure. If other heart issues are present, they may be repaired during the same surgery. After pulmonary valve replacement, antibiotics may be needed before certain dental procedures to prevent an infection called endocarditis.

Regular follow-up care is important to monitor heart function and ensure the best long-term outcome.