Pulmonary Valve Stenosis—Child

(Pulmonary Stenosis—Child)
  • Definition

    Pulmonary valve stenosis is when the pulmonary valve is thickened or can't open fully.
    The heart pumps blood out of the right side of the heart, through the pulmonary valve, to the lungs. When this valve is not working properly it can decrease the amount of blood going to the lungs for oxygen or increase the work the heart muscle has to do to maintain it. Blood can also back up into the heart. The condition can be mild to severe.
    Heart Chambers and Valves
    heart anatomy
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  • Causes

    Pulmonary stenosis is caused by abnormal development of the heart valve before birth. In most cases, it is not known exactly why it happens.
  • Risk Factors

    Factors that may increase the risk of 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
    • Maternal smoking 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 child during a physical exam.
    These symptoms may be caused by other severe 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. Your doctor may suspect a heart valve problems if there is a heart murmur. To confirm the diagnosis, an electrocardiogram and images of the heart and its structures may be taken with:
  • Treatment

    If your child has mild pulmonary valve stenosis, immediate treatment may not be needed. Your doctor will monitor your child's condition to look for potential problems. Other treatment options include:
    Surgery
    Your child may need surgery to prevent heart damage. Common types of heart valve surgery include:
    • Balloon valvuloplasty —A balloon is inflated in the valve to stretch out the surrounding tissue. This may provide temporary relief of symptoms but the valve may become blocked again.
    • Open heart surgery—to repair valves that can not be opened with balloon valvuloplasty.
    • Valve replacement—the valve is replaced with a mechanical or tissue valve
    Complication Management
    There are several steps your child can take to avoid some of the complications of pulmonary valve stenosis:
    • Get regular medical care. This includes basic checkups and heart tests.
    • Take antibiotics before any dental cleaning, dental work, or other invasive procedures if it is recommended by your doctor. Not all patients with valve stenosis need antibiotics for these procedures.
    • Eat a healthy diet that is low in salt. Work with the doctor or dietician to plan a healthy diet for your child. This may help decrease the pressure in your child’s heart and improve symptoms.
    • Monitor blood pressure at home. Inform the doctor if your child seems to be developing high blood pressure .
  • Prevention

    Ways to prevent heart defects are not entirely clear and may not always be possible. However, good prenatal care may reduce your risk of having a child with a heart defect. During pregnancy:
    • Visit your obstetrician or midwife regularly. 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/

    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 June 20, 2013.

    Johns Hopkins University, Cove Point Foundation. Pulmonary stenosis. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=pulmonarystenosis3 . Accessed June 20, 2013.

    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 June 20, 2013.

    Pulmonary stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated October 10, 2012. Accessed June 20, 2013.

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