Pulmonary Valve Disorders
What are pulmonary valve disorders?
What are the symptoms of pulmonary valve disorders?
What causes pulmonary valve disorders?
How are pulmonary valve disorders diagnosed?
How can pulmonary valve disorders be treated?
The pulmonary valve is one of your heart's four valves; it controls the flow of blood between the lower right chamber of your heart and your pulmonary artery. A valve is several little flaps of tissue that open and close each time your heart beats, sending blood in the correct direction—in the case of your pulmonary valve, out of your right ventricle toward your lungs, where it can be reoxygenated. When it's working as it should, the flaps of the pulmonary valve open to allow the ventricle to pump oxygen-depleted blood into the pulmonary artery, then they close again while the ventricle refills, to keep blood from flowing backward out of the pulmonary artery.
Disorders of the pulmonary valve are much less common than problems with the heart's other valves, But the following conditions are among those that can affect the function of the pulmonary valve:
- Pulmonary valve prolapse, which means the flaps of the valve don't close completely and form a tight seal, as they should. Instead, they flop or bulge backward into the right ventricle. ("Prolapse" comes from Latin words meaning "to fall out.")
- Pulmonary valve regurgitation, which means your pulmonary valve is leaky and allows blood to flow backward into the right ventricle. ("Regurgitation" comes from Latin words meaning "to engulf again.")
- Pulmonary valve stenosis, which means the flaps of the valve have thickened, stiffened or stuck together and are thus unable to open completely; this partially blocks the flow of blood from the right ventricle into the pulmonary artery. ("Stenosis" comes from a Latin word meaning "to make narrow.") This is a very rare disorder, usually present from birth, sometimes as one of the four conditions that make up of a rare defect called tetralogy of Fallot.
Some people with pulmonary valve disorders experience few or no symptoms, but if the condition is not treated it can result in serious complications, including congestive heart failure or a condition called cardiomyopathy, in which the heart muscle becomes enlarged, thickened or stiffened.
Symptoms of a disease are indications that can be detected by the patient, such as pain or fatigue (while signs are indications that can be detected by a doctor, such as the results of a blood test or an X-ray). Some people with pulmonary valve conditions experience no symptoms. If symptoms do occur, they often come on gradually.
The symptoms for the various disorders of the pulmonary valve are similar and include shortness of breath, especially if it's brought on by exertion; chest pain; lightheadedness or dizziness; loss of consciousness (fainting); fatigue; and swelling in your ankles, feet, legs and abdomen or in the veins of your neck.
Some disorders of the pulmonary valve, especially pulmonary valve stenosis, are congenital defects, present from birth. In most cases of congenital heart defects, there is simply no way of knowing what caused them.
Pulmonary valve prolapse and regurgitation are most often caused by pulmonary hypertension (high blood pressure in the lungs, often as a result of chronic obstructive pulmonary disease). Among less common causes of such disorders are endocarditis (an inflammation of the lining and valves of the heart); pulmonary artery dilation (enlargement of the artery that runs from the heart to the lungs); and rheumatic fever (an inflammatory disease often triggered by the strep bacterium; however, antibiotics have made it much less common in the U.S. than in the past).
If a damaged pulmonary valve is symptomless, it can sometimes be identified during a routine physical exam. For example, if your doctor detects signs such as a heart murmur (a "swooshing" sound perceptible through a stethoscope), it may lead to a suspicion of pulmonary valve disease.
If such signs—or the presence of symptoms—cause your doctor to suspect that you may have a diseased pulmonary valve, certain diagnostic tests will likely be conducted. They may include an angiogram (also referred to as cardiac catheterization), which uses opaque dye to image your cardiovascular system; a chest X-ray; an electrocardiogram (also referred to as an ECG or EKG), which measures and records your heart's electrical activity; an echocardiogram (an ultrasound image of your chest); or an MRI of your heart.
No treatment may be needed if a disorder of the pulmonary valve is mild and causes no symptoms. For symptomatic disorders of the pulmonary valve, medications—such as drugs that improve the blood flow, reduce the likelihood of blood clots, or stabilize an abnormal heartbeat, as well as diuretics, which reduce the fluid buildup in your tissues—may relieve some symptoms and delay the development of complications.
In the case of a seriously damaged pulmonary valve, however, surgery may be indicated. While there are risks to surgery, they need to be balanced against the risks that your valvular disease will progress otherwise.
Page reviewed on: Jun 26, 2015
Page reviewed by: Jock McCullough, MD
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