Pulmonary Valve Stenosis -- Child

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(Pulmonary Stenosis—Child)

Definition

In a normal heart, blood flows from the body into the right atrium and on to the right ventricle. Blood is then pumped out of the heart through the pulmonary artery to the lungs. The blood picks up fresh oxygen in the lungs. Then the blood returns to the left atrium of the heart and goes into the left ventricle. There, it is pumped out through the aorta to deliver oxygen-rich blood to the rest of the body.

Heart Chambers and Valves

Blood Flow Through the Heart

Pulmonary valve stenosis is a heart defect. This defect happens when the pulmonary valve (the valve between the right ventricle and pulmonary artery) is thickened or partially fused. When this occurs, the valve does not work properly. Blood cannot move efficiently from the heart to the lungs.

The condition can be mild to severe. Other heart defects may be present as well.

Causes

Pulmonary stenosis is a congenital defect. This means that the baby is born with it. In most cases, it is not known exactly why the heart develops abnormally.

Risk Factors

For many heart defects, the risk factors are unclear. Risk factors for pulmonary valve stenosis may include:

Family history of congenital heart defect
Certain chromosomal disorders
Other heart defects
Previous pregnancy with fetal heart abnormalities or miscarriage
Being infected with a virus during pregnancy

Symptoms

Symptoms may include:

Heavy or rapid breathing
Shortness of breath
Blue or pale grayish skin color
Fatigue
Rapid heart rate
Swelling of the feet, ankles, eyelids, and abdomen
Urinating less

Your doctor may also detect a heart murmur in your baby during a physical exam.

These symptoms may be caused by other conditions. If your child has any of these, talk to the doctor right away.

Diagnosis

The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:

Echocardiogram —an imaging test that uses sound waves to look at the size, shape, and motion of the heart
Chest x-ray —an imaging test that uses low amounts of radiation to create an image of the chest
Electrocardiogram —a test that measures the electrical activity of the heart
MRI scan —a test that uses magnetic waves to make pictures of structures inside the chest
CT scan —a type of x-ray that uses a computer to make pictures of structures inside the chest

Treatment

Talk with your doctor about the best treatment plan for your child. Treatment options include:

Procedures

One type of procedure that can be done is called percutaneous balloon valvuloplasty . During this procedure, a balloon is threaded up to the pulmonary valve. The balloon is inflated to stretch the valve and increase blood flow.

In some cases, the valve can be widened with surgery, but in other cases, the valve will need to be replaced with a human or synthetic valve.

Watchful Waiting

If the condition is mild, the doctor may choose to monitor your child’s health instead of doing surgery right away.

Lifelong Monitoring

Your child will need to have regular visits with a heart doctor. Depending on the severity of the condition and the treatment needed, your child may need to take antibiotics before medical or dental procedures to prevent a heart infection.

Prevention

Ways to prevent heart defects are not entirely clear and may not always be possible. However, here are some things you can do reduce your risk of having a child with a heart defect:

Get good prenatal care.

Visit your obstetrician or midwife regularly to monitor your health and the health of your baby. (Prenatal ultrasound and certain genetic tests may detect a heart defect in a growing fetus.)
Make sure you are practicing a healthy lifestyle. Practice nutritious eating habits and take prenatal vitamins.
Do not drink alcohol, smoke, or use drugs during pregnancy.

RESOURCES

American Family Physician http://www.aafp.org/

American Heart Association http://www.americanheart.org/

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca/

Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca/splash/

References

American Heart Association. Pulmonary valve stenosis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Pulmonary-Valve-Stenosis%5FUCM%5F307034%5FArticle.jsp . Accessed July 7, 2010.

DynaMed Editors. Evaluation of the infant for congenital heart disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 14, 2010. Accessed July 7, 2010.

Johns Hopkins University, Cove Point Foundation. Pulmonary stenosis. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=pulmonarystenosis3 . Accessed July 7, 2010.

Lucile Packard Children’s Hospital at Stanford. Pulmonary stenosis. Lucile Packard Children’s Hospital at Stanford website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/cardiac/ps.html . Accessed July 22, 2010.

Mayo Clinic. Atrioventricular canal defect. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/atrioventricular-canal-defect/DS00745/DSECTION=risk-factors . Accessed July 7, 2010.

Revision Information

Reviewer: Kari Kassir, MD
Review Date: 06/2012 -
Update Date: 06/06/2012 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Danville Regional Medical Center

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