Pulmonary Regurgitation

ByGuy P. Armstrong, MD, Waitemata District Health Board and Waitemata Cardiology, Auckland
Reviewed/Revised Jun 2025 | Modified Jul 2025
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Pulmonary (pulmonic) regurgitation is leakage of blood backward through the pulmonary valve each time the right ventricle relaxes.

  • Pulmonary regurgitation usually does not cause symptoms.

  • Doctors make the diagnosis because of physical examination findings, and they use echocardiography to confirm the diagnosis.

  • The underlying disorder is treated.

(See also Overview of Heart Valve Disorders and the video The Heart.)

The pulmonary valve is in the opening between the right ventricle and the blood vessels going to the lungs (pulmonary arteries). The pulmonary valve opens as the right ventricle contracts to pump blood into the lungs. When the pulmonary valve does not close completely, some blood leaks backward from the pulmonary arteries into the right ventricle, termed regurgitation.

In adults, the most common cause of pulmonary regurgitation is:

The high pressure stresses the valve, causing it to leak.

Much less common causes are:

  • A birth defect of the valve

  • Infection of the valve (infective endocarditis)

  • Pulmonary artery enlargement

  • Surgery to repair a heart defect which has caused valve leakage

Pulmonary regurgitation usually causes no symptoms. Sometimes people develop swollen ankles or fatigue.

Diagnosis of Pulmonary Regurgitation

  • Echocardiography

Often pulmonary regurgitation is detected during an examination done for some other reason. Through a stethoscope, doctors may hear a characteristic murmur produced by the blood leaking backward through the pulmonary valve.

Echocardiography, which uses ultrasound waves, can produce an image of the leaky valve and the amount of blood leaking, so that the severity of the regurgitation can be determined.

Electrocardiography (ECG) and chest x-rays also provide useful information.

Treatment of Pulmonary Regurgitation

  • Treament of the underlying disorder

The condition causing pulmonary regurgitation is treated. Treatment may involve taking medications such as sildenafil or bosentan to reduce The condition causing pulmonary regurgitation is treated. Treatment may involve taking medications such as sildenafil or bosentan to reducepulmonary hypertension. Rarely, in other cases, the pulmonary valve must be replaced.

More Information

The following English-language resource may be useful. Please note that The Manual is not responsible for the content of this resource.

  1. American Heart Association: Heart Valve Disease: Provides comprehensive information on diagnosis and treatment of diseases of the heart valves

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