Diagnosis

Pulmonary valve stenosis is often diagnosed in childhood, but sometimes it isn't detected until later in life. If your doctor hears a heart murmur during a routine checkup and suspects pulmonary stenosis, he or she may then use a variety of tests to confirm the diagnosis.

  • Echocardiogram. Sound waves bounce off your heart and produce moving images that can be viewed on a video screen. This test is useful for checking the structure of the pulmonary valve, the location and severity of the narrowing (stenosis), and right ventricle size and function.

    Doctors may also perform a 3-D echocardiogram.

  • Electrocardiogram. During this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles. The electrodes measure electrical activity in your heart, which is recorded on paper. This test helps determine if the muscular wall of your right ventricle is thickened (right ventricular hypertrophy).

  • Other imaging tests. MRI and CT scans are sometimes used to confirm the diagnosis of pulmonary valve stenosis.

  • Cardiac catheterization. During this procedure, your doctor inserts a thin, flexible tube (catheter) into an artery or vein in your groin and threads it up to your heart or blood vessels. Dye injected through the catheter makes your blood vessels visible on X-rays. Doctors also use cardiac catheterization to measure the blood pressure in the heart chambers and blood vessels.

    Doctors generally use this test only if they suspect that you or your child will need a balloon valvuloplasty, a procedure that can be done at the same time as cardiac catheterization.

Treatment

Pulmonary valve stenosis is classified as mild, moderate or severe, depending on a measurement of the blood pressure difference between the right ventricle and pulmonary artery. Mild pulmonary stenosis that isn't causing symptoms doesn't usually require treatment, just routine checkups.

Depending on the degree of obstruction, more-serious cases may need either a balloon valvuloplasty or open-heart surgery.

  • Balloon valvuloplasty. Using the small tube that was threaded through a vein in your leg to your heart for a cardiac catheterization, your doctor places an uninflated balloon through the opening of the narrowed pulmonary valve. He or she then inflates the balloon, widening the narrowed valve to increase blood flow, and then removes the balloon.

    The most common side effect of a balloon valvuloplasty is blood leakage back through the pulmonary valve (valve regurgitation). As with most procedures, there is a risk of bleeding, infection or blood clots.

  • Open-heart surgery. When a balloon valvuloplasty isn't an option, you may require open-heart surgery. During surgery, your doctor either repairs the pulmonary artery or valve or replaces the valve with an artificial valve. Repairs to other congenital heart defects can be made during the surgery, as well. There's a slight risk of bleeding, infection or blood clots associated with the surgery.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

While there's little you can do to prevent pulmonary valve stenosis, you can take steps to ensure you won't develop complications of your condition.

Your doctor will also likely recommend regular follow-up appointments to evaluate your condition.

Preventive antibiotics

In most cases, you won't need to take antibiotics to prevent an infection of the inner lining of the heart (infective endocarditis). Your doctor will recommend antibiotics if you've had endocarditis before or if you've had a pulmonary valve replacement.

Heart-healthy lifestyle

Adopting a heart-healthy lifestyle decreases your risk of developing other types of heart disease, such as a heart attack. Lifestyle changes to talk to your doctor about include:

  • Quitting smoking
  • Eating a heart-healthy diet, such as a variety of fruits and vegetables, low-fat dairy products, whole grains, and lean meat
  • Maintaining a healthy weight
  • Regular physical activity

Pregnancy

Pregnancy generally isn't a problem for women who have mild and moderate pulmonary valve stenosis. If you have severe pulmonary valve stenosis, the risks of complications during labor and delivery are higher than those for women without the condition. If necessary, it's possible to undergo a balloon valvuloplasty during pregnancy.

Preparing for your appointment

You're likely to start by seeing your family doctor, a general practitioner or your child's doctor. You'll probably then be referred to a doctor trained in evaluating and treating heart conditions (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 doctor.

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

  • What's the most likely cause of my or my child's 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, and which do you recommend?
  • What are the risks of a balloon valvuloplasty or open-heart surgery?
  • I have other health conditions. How can I best manage them together?
  • Do I need to restrict my or my child's activity?
  • 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 doctor is likely to ask you a number of questions, including:

  • When did your symptoms begin?
  • Have your symptoms been continuous or occasional?
  • Are your symptoms worse when you exercise or when you're lying down?
  • Does anything seem to improve your symptoms?
Dec. 06, 2017
References
  1. Stout K. Clinical manifestations and diagnosis of pulmonic stenosis in adults. http://www.uptodate.com/contents/search. Accessed July 25, 2017.
  2. Stout K. Natural history and treatment of pulmonic stenosis in adults. https://www.uptodate.com/contents/search. Accessed July 25, 2017.
  3. Pulmonary valve stenosis and regurgitation. American Heart Association. http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Pulmonary-Valve-Stenosis_UCM_307034_Article.jsp#.WZM_HlGQzIU. Accessed Aug. 15, 2017.
  4. Peng LF, et al. Pulmonic stenosis (PS) in neonates, infants, and children. https://www.uptodate.com/contents/search. Accessed July 25, 2017.
  5. Heart valve disease. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/hvd. Accessed July 25, 2017.
  6. Connolly HM. Carcinoid heart disease. https://www.uptodate.com/contents/search. Accessed Aug. 15, 2017.

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