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Pulmonic Stenosis

by Guy P. Armstrong, MD

Pulmonic (pulmonary) stenosis is a narrowing of the pulmonary valve opening that slows blood flow from the right ventricle to the pulmonary artery. It is often present at birth (congenital) and thus affects children.

Pulmonic stenosis, which is rare among adults, is usually due to a birth defect (see Pulmonary Valve Stenosis). When the stenosis is severe, it is usually diagnosed during childhood, because it causes a loud heart murmur. Severe pulmonic stenosis occasionally causes heart failure in children but often does not cause symptoms until adulthood. Symptoms include chest pain (angina), shortness of breath, and fainting.

Through a stethoscope, doctors may hear the characteristic murmur of pulmonic stenosis. Echocardiography (see Echocardiography and Other Ultrasound Procedures) can produce an image of the narrowed valve opening and show the amount of blood passing through the valve, so that the severity of the stenosis can be determined.

In people with symptoms and/or severe stenosis detected by echocardiography, balloon valvuloplasty may be done. In this procedure, the valve is stretched open using a balloon-tipped catheter threaded through a vein and eventually into the heart. Once inside the valve, the balloon is inflated, separating the valve cusps.