The Pulmonalklappeninsuffizienz (PI) is the final failure of the pulmonary valve that causes a backflow of the blood from the pulmonary artery into the RV during diastole. The most common reason for this is the pulmonary arterial hypertension. The PI is usually asymptomatic. Findings are a diastolic decrescendo noise. The diagnosis is made by echocardiography. Usually, no specific treatment is necessary, except for pulmonary arterial hypertension.

The Pulmonalklappeninsuffizienz (PI) is the final failure of the pulmonary valve that causes a backflow of the blood from the pulmonary artery into the RV during diastole. The most common reason for this is the pulmonary arterial hypertension. The PI is usually asymptomatic. Findings are a diastolic decrescendo noise. The diagnosis is made by echocardiography. Usually, no specific treatment is necessary, except for pulmonary arterial hypertension.

(See also Overview of the heart valve diseases.) The Pulmonalklappeninsuffizienz (PI) is the final failure of the pulmonary valve that causes a backflow of blood from the pulmonary artery into the RV during diastole. The most common reason for this is the pulmonary arterial hypertension. The PI is usually asymptomatic. Findings are a diastolic decrescendo noise. The diagnosis is made by echocardiography. Usually, no specific treatment is necessary, except for pulmonary arterial hypertension. The most common cause of pulmonary valve is pulmonary far Secondary hypertension Less common causes include infectious endocarditis, Remedy Operative of tetralogy of Fallot, idiopathic pulmonary arterial dilation are congenital valvular Rare causes carcinoid syndrome Rheumatic fever catheter-induced trauma A severe pulmonary regurgitation is rare and is caused by the most common an isolated congenital defect that affects the dilatation of the pulmonary artery and the Pulmonalklappenrings. A PI can thus lead to the development of RV dilation and finally an RV dysfunction and induced heart failure, but in most cases carries the pulmonary arterial hypertension to this complication far more at. Rarely, an acute, due RV dysfunction heart failure develops when endocarditis caused the PI. Symptoms and complaints The PI is usually asymptomatic. Few patients develop symptoms and clinical signs by RV dysfunction-induced heart failure. Palpable signs of pulmonary arterial hypertension and RV hypertrophy are attributable. They include a palpable pulmonary component (P2) of the second heart sound (S2) on the left upper sternal and a sustained RV-pulse amplified in amplitude at the left middle and lower sternal a. On auscultation of the heart sound is normal 1 (S1). S2 may be cleaved or singular. If it is cleaved, P2 can be heard loudly and shortly after the aortic component of S2 (A2) because of pulmonary artery hypertension; or P2 can be delayed due to the increased RV stroke volume. S2 can be singular in promptem closing of the pulmonary valve, which closes with a mixed A2-P2, or, rarely, in congenital absence of the pulmonary valve. 3. A right heart sound (S3), 4. heart sound (S4) or both may be audible in by RV dysfunction induced heart failure or RV hypertrophy; these sounds can be distinguished from LV heart sounds as they are linksparasternal located in the 4th ICR and louder with inspiration. The sound of PI due to the pulmonary hypertension is a high-frequency frühdiastolisches decrescendo noise that begins with and ends before P2 S1 and the right to the middle sternal radiates (Graham Steell murmur); it is best heard at the upper left sternal edge with the diaphragm of the stethoscope when the patient holds his breath and sits upright. The sound of the PI without pulmonary arterial hypertension is shorter, low-frequency (in the rough quality) and begins to P2. Both noises can resemble the sound at a Aortenklappeninsuffizienz, but they can at Inspiration (which makes the PI sound louder) are distinguished and upon release of the Valsalva maneuver. Upon release of the Valsalva maneuver the PI noise is louder now (since an immediate venous return to the right side of the heart takes place), while the sound of aortic insufficiency requires four to five strokes until it does. Likewise, a soft PI noise during inspiration can still be soft, since this noise is usually heard in the second ICR where the inspiration pushes the stethoscope from the heart. In some forms of congenital heart disease the sound of heavy PI is relatively short, since the pressure gradient between the pulmonary artery and the right ventricle in diastole is quickly compensated. Diagnostic echocardiography The PI is usually discovered by accident during a physical examination or Doppler chokardiographie, which is performed for other reasons. A slight PI is a normal echocardiographic findings in which no action must be taken. An ECG and a chest X-ray recording are usually carried out. The ECG may show signs of RV hypertrophy; the Rönthenthorax can show an enlargement of the right ventricle and findings of the underlying pulmonary arterial hypertension. Treatment Treating the cause rare heart valve replacement The treatment is to treat the cause of pulmonary regurgitation. A pulmonary valve replacement is an option if symptoms or signs induced RV dysfunction heart failure develop, but the results and risks are unclear, since the need for a valve replacement so rarely present. Summary Pulmonary regurgitation (PR) is usually caused by pulmonary hypertension. Hemodynamic consequences usually occur due to the cause and not due to the PI itself. The heart sounds are created when the PI occurs due to pulmonary arterial hypertension, include a high-frequency frühdiastolisches decrescendo noise that begins with and ends before P2 S1 and radiates to the middle right sternal; it is best heard at the upper left sternal edge when the patient holds his breath and sits upright. The sound of the PI without pulmonary hypertension is shorter, low-frequency and starts to P2. Treatment focuses on the cause, a heart valve replacement is not usually required.

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