PULMONIC STENOSIS
Pulmonic stenosis is a narrowing or thickening of the pulmonic valve.
Etiology
Usually, congenital.
Rheumatic fever.
Narrowing of pulmonary valve.
Risk Factors
Maternal smoking during pregnancy.
Infection with a virus during pregnancy.
Carcinoid syndrome.
Noonan's syndrome.
Clinical Manifestations
Dyspnea Chest pain
Syncope Poor weight gain
Ascites Shortness of breath on exertion.
Hepatomegaly Bluish discoloration of skin in some patients.
Peripheral edema Abdominal distension.
Sudden death Fatigue
Diagnostic Evaluation
Auscultation: Systolic thrill best heard at the left sternal boarder.
Echocardiogram: the structure of the pulmonary valve, the location and severity of
the stenosis.
Electrocardiogram: to determine whether the muscular wall of right ventricle is
thickened or not.
MRI and CT: to confirm the diagnosis of pulmonary valve stenosis.
Cardiac catheterization: to measure the blood pressure in the heart chambers and
blood vessels.
Management
Medical Management
Patients with minor symptoms should be treated medically. Where there are other heart
defects, medicines may be used to:
ACE inhibitors that can open blood vessels more fully.
Beta blockers
Diuretics
Anticoagulants (Warfarin)
Surgical Management
Percutaneous balloon valvuloplasty
Open heart surgery
Nursing Management
Monitor patient's vital signs.
Provide emotional and psychological support to patient
Encourage patient and family to ventilate their feelings, concerns and ask questions.
Advice patient to eat a heart healthy diet.
Instruct patient to maintain a healthy weight.
Instruct patient to quit smoking.
Teach patient if he/she has severe pulmonic stenosis, the risks of complications during
labor and delivery are higher.
Complications
Congestive heart failure
1
Pulmonic stenosis is a narrowing or thickening of the pulmonic valve.
Etiology
Usually, congenital.
Rheumatic fever.
Narrowing of pulmonary valve.
Risk Factors
Maternal smoking during pregnancy.
Infection with a virus during pregnancy.
Carcinoid syndrome.
Noonan's syndrome.
Clinical Manifestations
Dyspnea Chest pain
Syncope Poor weight gain
Ascites Shortness of breath on exertion.
Hepatomegaly Bluish discoloration of skin in some patients.
Peripheral edema Abdominal distension.
Sudden death Fatigue
Diagnostic Evaluation
Auscultation: Systolic thrill best heard at the left sternal boarder.
Echocardiogram: the structure of the pulmonary valve, the location and severity of
the stenosis.
Electrocardiogram: to determine whether the muscular wall of right ventricle is
thickened or not.
MRI and CT: to confirm the diagnosis of pulmonary valve stenosis.
Cardiac catheterization: to measure the blood pressure in the heart chambers and
blood vessels.
Management
Medical Management
Patients with minor symptoms should be treated medically. Where there are other heart
defects, medicines may be used to:
ACE inhibitors that can open blood vessels more fully.
Beta blockers
Diuretics
Anticoagulants (Warfarin)
Surgical Management
Percutaneous balloon valvuloplasty
Open heart surgery
Nursing Management
Monitor patient's vital signs.
Provide emotional and psychological support to patient
Encourage patient and family to ventilate their feelings, concerns and ask questions.
Advice patient to eat a heart healthy diet.
Instruct patient to maintain a healthy weight.
Instruct patient to quit smoking.
Teach patient if he/she has severe pulmonic stenosis, the risks of complications during
labor and delivery are higher.
Complications
Congestive heart failure
1
