Pulmonary valve stenosis

Pulmonary valve stenosis is often diagnosed in childhood. But it may not be detected until later in life.

A health care provider uses a stethoscope to listen to the heart. A whooshing sound, called a heart murmur, may be heard. The sound is caused by choppy blood flow across the narrowed valve.

Tests to diagnose pulmonary valve stenosis include:

• Electrocardiogram (ECG or EKG). This quick and painless test records the electrical signals in the heart. Sticky patches, called electrodes, are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which displays the test results. An electrocardiogram (ECG) can show how the heart is beating and may reveal signs of heart muscle thickening.
• Echocardiogram. An echocardiogram uses sound waves to produce images of the heart. This common test shows how the heart beats and pumps blood. An echocardiogram can show the shape of the pulmonary valve. The test can show how much of the valve is narrowed.

• Cardiac catheterization. A thin tube called a catheter is inserted into the groin and threaded through the blood vessels to the heart. Dye flows through the catheter into the blood vessels to make them show up more clearly on X-rays. This part of the test is called a coronary angiogram.

  During the test, pressures within the heart can be measured to see how forcefully blood pumps through the heart. A provider can determine the severity of pulmonary stenosis by checking the difference in pressure between the right lower heart chamber and the lung artery.

• Other imaging tests. Magnetic resonance imaging (MRI) and computed tomography (CT) scans are sometimes used to confirm the diagnosis of pulmonary valve stenosis.

If you have mild pulmonary valve stenosis without symptoms, you may only need occasional health checkups.

If you have moderate or severe pulmonary valve stenosis, you may need a heart procedure or heart surgery. The type of procedure or surgery done depends on your overall health and the appearance of your pulmonary valve.

Surgeries or other procedures

Pulmonary valve stenosis treatment may include:

• Balloon valvuloplasty. The provider inserts a flexible tube with a balloon on the tip into an artery, usually in the groin. X-rays help guide the tube, called a catheter, to the narrowed valve in the heart. The balloon inflates, making the valve opening larger. The balloon is deflated. The catheter and balloon are removed.

  Valvuloplasty may improve blood flow through the heart and reduce pulmonary valve stenosis symptoms. But the valve may narrow again. Some people need valve repair or replacement in the future.

• Pulmonary valve replacement. If balloon valvuloplasty isn't an option, open-heart surgery or a catheter procedure may be done to replace the pulmonary valve. If there are other heart problems, the surgeon may repair those during the same surgery.

  People who have had pulmonary valve replacement need to take antibiotics before certain dental procedures or surgeries to prevent endocarditis.

If you have valve disease, it's important to take steps to keep your heart healthy. Certain lifestyle changes can decrease your risk of developing other types of heart disease or having a heart attack.

Lifestyle changes to talk about with your health care provider include:

• Quitting smoking.
• Eating a heart-healthy diet that includes fruits and vegetables, low-fat dairy products, whole grains, and lean meat.
• Maintaining a healthy weight.
• Getting regular exercise.

If you or your child has valve disease, you will likely be referred to a doctor trained in evaluating and treating heart conditions. This type of provider is called a cardiologist.

Here's some information to help you get ready for your appointment.

What you can do

• Write down symptoms you or your child has, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including major stresses or recent illnesses.
• List all medications, vitamins and supplements you or your child takes.
• Write down questions to ask the health care provider.

Preparing a list of questions can help you make the most of your time with your health care provider. For pulmonary valve stenosis, some basic questions include:

• What's the most likely cause of the symptoms?
• Are there other possible causes?
• What tests are needed? Do these tests require any special preparation?
• Is pulmonary valve stenosis temporary or long lasting?
• What treatments are available? Which do you recommend and why?
• What are the risks of a balloon valvuloplasty or open-heart surgery?
• Are there any activity restrictions?
• Are there brochures or other printed material that I can take? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask many questions, including:

• When did symptoms begin?
• Do the symptoms come and go, or do they always happen?
• Do the symptoms get worse during activity or when lying down?
• Does anything seem to improve symptoms?