What is Pulmonary Valvular Disease

Pulmonary Valvular Disease is a disease of the heart, namely the pulmonary valve between the right ventricle and the pulmonary artery.

Statistics on Pulmonary Valvular Disease

Pulmonary heart disease includes pulmonary valve stenosis and pulmonary valve regurgitation. Both these lesions are rare although pulmonary regurgitation is more common than pulmonary stenosis. The incidence depends on the incidence of the underlying cause.

Risk Factors for Pulmonary Valvular Disease

Pulmonary stenosis (PS) is rare and usually present at birth, associated with Fallot’s tetralogy. Acquired PS can occasionally be caused by rheumatic heart disease or the carcinoid syndrome.

Pulmonary regurgitation (PR) is the more common pulmonary valvular disorder and is associated with pulmonary hypertension.

Progression of Pulmonary Valvular Disease

PS: causes right ventricular hypertrophy and eventually right ventricular failure. Reduced perfusion of the pulmonary vascular bed results in lethargy and syncope.

PR: usually causes no symptoms and treatment is not required.

How is Pulmonary Valvular Disease Diagnosed?

Chest x-ray: may show evidence of right ventricular hypertrophy and of right atrial hypertrophy in PS.

ECG may show evidence of hypertrophy too.

Prognosis of Pulmonary Valvular Disease

The prognosis of PS depends on its severity and associated features. Severe stenosis (constriction) is life threatening to the inadequate perfusion of the lungs. Mild stenosis may be asymptomatic (symptomless). Stenosis associated with Fallot’s tetralogy carries a different prognosis owing to the other abnormalities present in this abnormality.
PR has an excellent prognosis.

How is Pulmonary Valvular Disease Treated?

PR usually requires no treatment.

PS should be treated by surgery, usually by replacement of the valve. Heart failure should be treated medically as appropriate.

Pulmonary Valvular Disease References

  1. Hurst’s The Heart 8th Edition, McGRAW-HILL 1994.
  2. Kumar and Clark Clinical Medicine 4th Edition, W.B SAUNDERS 1998.