The pulmonary valve (PS) is the narrowing of the pulmonary outflow tract, which leads to a blood flow obstruction of the RV into the pulmonary artery during systole. Most cases are congenital, many remain asymptomatic until adulthood. Findings are a crescendo-decrescendo ejection noise. The diagnosis is made by echocardiography. In symptomatic patients and those with high pressure gradient, a balloon valvuloplasty is required.

The pulmonary valve (PS) is the narrowing of the pulmonary outflow tract, which leads to a blood flow obstruction of the RV into the pulmonary artery during systole. Most cases are congenital, many remain asymptomatic until adulthood. Findings are a crescendo-decrescendo ejection noise. The diagnosis is made by echocardiography. In symptomatic patients and those with high pressure gradient, a balloon valvuloplasty is required.

(See also Overview of the heart valve diseases.) The pulmonary valve stenosis (PS) is the narrowing of the pulmonary outflow tract, which leads to blood flow obstruction of RV into the pulmonary artery during systole. Most cases are congenital, many remain asymptomatic until adulthood. Findings are a crescendo-decrescendo ejection noise. The diagnosis is made by echocardiography. In symptomatic patients and those with high pressure gradient, a balloon valvuloplasty is required. Etiology Pulmonary stenosis is usually congenital and mainly affects children; The stenosis may be valvular or just below the flap in the outflow tract (infundibul√§r). It is generally a component of tetralogy of Fallot. Rare causes include Noonan syndrome (a familial syndrome similar to Turner’s syndrome, but without chromosomal disorder) and carcinoid syndrome in adults. Symptoms and complaints Many children with pulmonary stenosis remain asymptomatic for years and stand to adulthood no doctor before. Even then, many patients remain asymptomatic. If symptoms develop pulmonary stenosis, aortic valve stenosis are similar to those of this (syncope, angina, dyspnea). Visible and palpable signs reflect the effects of RV hypertrophy and include a prominent A-wave in Jugularvenenpuls one (due to a forceful atrial contraction against the hypertrophied RV), is a right precordial lift and a parasternales systolic thrill in the second ICR. Auscultation auscultation the 1st heart sound (S1) and the normal heart sound 2. (S2) is cleaved far as the pulmonary ejection is extended (pulmonary component of S2 [P2] is delayed). When RV failure and RV hypertrophy of the 3rd and 4th heart sound (S3 and S4) are rarely heard in the 4th ICR. Clicking in the congenital PS arises, as it is believed by the abnormally high Ventrikelwandspannung. The click occurs in early systole (very close to S1) and is not influenced by hemodynamic changes. A harsh crescendo-decrescendo ejection sound can be heard and the best link-saving aster-dimensional in the second (valvular stenosis) or fourth (infundibular stenosis) ICR heard with the diaphragm of the stethoscope when the patient leans forward. Unlike the Aortenklappenstenoseger√§usch the sound of a pulmonary stenosis does not radiate and the Crescendo component extended if the stenosis increases. The noise is loud immediately upon release of the Valsalva maneuver and inspiration; This effect may be heard under certain circumstances only when the patient standing. Diagnosis Echocardiography diagnosis of pulmonary stenosis is confirmed by Doppler echocardiography, which can classify the severity as mild: peak gradient <36 mmHg Moderate: 36-64 mmHg peak gradient focus: peak gradient> 64 mmHg, the ECG may be normal, an RV hypertrophy or show a right bundle branch block. A right heart catheterization is indicated when two levels of obstruction are suspected (valvular and infundibul√§r) when the clinical and echocardiographic findings are different or before an intervention. Sometimes treatment balloon valvuloplasty The prognosis of pulmonary stenosis is generally good even without treatment and continues to improve with appropriate intervention. The treatment of pulmonary stenosis by means Balloon valvuloplasty displayed carried out with normal systolic function and a peak gradient> 40 to 50 mmHg in symptomatic patients and asymptomatic patients. A percutaneous valve replacement can be offered in most selected centers for congenital heart disease, especially younger patients or those with multiple previous interventions to reduce the number of open-heart surgery. If a surgical valve replacement is necessary bioprosthetic valves are preferred because of the high rate of thrombosis right-sided mechanical heart valves. Summary pulmonary stenosis is usually congenital, symptoms (eg. As syncope, angina, dyspnea), however, do not occur normally into adulthood. The heart sounds include a wide splitting of S2 and a harsh crescendo-decrescendo ejection murmur, best heard in the second link saving aster dimensional or fourth ICR, if the patient leans forward. The noise is loud immediately upon release of the Valsalva maneuver and inspiration. The balloon valvuloplasty is performed in symptomatic patients and asymptomatic patients with normal systolic function and a peak gradient> 40 to 50 mmHg.

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