Pulmonary Valve Disease

Diagnosis

Some types of pulmonary valve stenosis are diagnosed at birth or shortly afterward. In other cases, pulmonary valve disease isn’t detected until later in life. During a physical exam, a healthcare professional listens to the heart with a stethoscope. A whooshing sound, known as a heart murmur, may suggest a problem with the pulmonary valve.

Tests are used to confirm the diagnosis and understand the severity of the condition.

Electrocardiogram (ECG or EKG)
This test records the heart’s electrical activity. Sticky patches called electrodes are placed on the chest and sometimes the arms and legs. The test shows how the heart is beating and can reveal rhythm problems or strain.

Echocardiogram
An echocardiogram uses sound waves to create moving images of the heart. It shows blood flow through the heart and valves and can reveal the shape and function of the pulmonary valve.

Chest X-ray
A chest X-ray provides images of the heart and lungs. It can show if the heart is enlarged or if there is fluid around the lungs, which may happen with certain types of valve disease.

Cardiac catheterization
While not often needed for diagnosis, cardiac catheterization may be used to measure how severe pulmonary valve disease is. A thin tube called a catheter is placed into a blood vessel and guided to the heart. Dye injected through the catheter helps arteries show clearly on X-ray images.

Other imaging tests
CT scans or MRI scans may be used to better define the pulmonary valve structure and confirm conditions such as pulmonary valve stenosis.

Heart valve disease stages
Once testing is complete, the results help determine the stage of pulmonary valve disease. Staging helps guide treatment decisions.

• Stage A: At risk. Risk factors for valve disease are present.
• Stage B: Progressive. The valve is mildly or moderately affected, but there are no symptoms.
• Stage C: Asymptomatic severe. The disease is severe, but symptoms have not yet appeared.
• Stage D: Symptomatic severe. The valve disease is severe and causing symptoms.

Treatment

Treatment for pulmonary valve disease depends on symptoms, disease stage and whether the condition is worsening. Some people only need regular checkups and imaging tests to monitor heart function. Others may need surgery or a procedure to repair or replace the valve.

Surgeries or procedures may be recommended when symptoms are significant or the valve is severely narrowed or leaking. The choice depends on overall health, age, how quickly the condition is progressing and whether other heart issues require correction.

Balloon valvuloplasty
This procedure is commonly used for infants and children with a narrowed pulmonary valve. A catheter with a balloon at the tip is guided to the heart. The balloon is inflated to widen the valve opening, then deflated and removed.

Pulmonary valve replacement surgery
If the valve cannot be repaired, it may be replaced with a mechanical valve or a valve made from cow, pig or human heart tissue. Biological tissue valves are often used to avoid long-term blood thinners.

Transcatheter pulmonary valve replacement
This minimally invasive option uses thin tubes inserted through a small incision. A new valve can be placed inside a failing replacement valve, known as a valve-in-valve procedure. This technique may reduce recovery time and avoid open-heart surgery.

Regular monitoring and timely treatment help protect heart function and improve long-term outcomes for people with pulmonary valve disease.