Pulmonary Valve Disease

The pulmonary valve (also called the pulmonic valve) controls the flow of blood from the lower right chamber (ventricle) of the heart into the pulmonary artery. It is the last valve before blood leaves the heart to go to the lungs to receive oxygen. The pulmonary valve keeps the blood moving in the right direction — from the right ventricle into the pulmonary artery.

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What is Pulmonary Valve Disease?

There are two main types of pulmonary valve disease:
• Pulmonary valve stenosis
• Pulmonary valve regurgitation

Pulmonary Valve Stenosis

Pulmonary valve stenosis occurs when an abnormality or scarring on or near the valve or the valves leaflets (flaps) restrict the opening through which blood flows. If the opening is too narrow, the heart has to work harder to push the blood through the opening into the pulmonary artery. Some blood may be left behind in the ventricle and the lungs may not get enough blood to support the body.
Pulmonary valve stenosis is most commonly a congenital defect, which means the valve did not develop properly before birth. However, it can also be caused by:
  • A defect present at birth (congenital)
  • An infection, such as rheumatic fever (an inflammatory disease that may develop after strep throat or scarlet fever) or endocarditis (an infection of the inner lining of the heart/endocardium)
  • Carcinoid syndrome (a group of symptoms that occur in patients with a rare type of slow-growing cancer called carcinoid. Carcinoid tumors excrete chemicals into the blood stream that can affect the heart.)
  • Noonan syndrome (a genetic disorder that may cause heart defects)

Mild pulmonary valve stenosis may not need treatment. However, moderate or severe pulmonary stenosis may put you at risk for an infection affecting the heart, such as endocarditis, or lead to heart failure or arrhythmia. Therefore, sometimes it may be necessary to repair or replace the valve.

Pulmonary Valve Regurgitation

Regurgitation or leaking occurs when the pulmonary valve’s leaflets don’t close tightly. When an abnormality or scarring doesn’t allow the valve to close completely, blood moves forward, but also leaks back into the ventricle (the lower left and right chambers of the heart). Pulmonary valve regurgitation limits the amount of blood that is pushed into the pulmonary article and that is available for oxygenation in the lungs.

Pulmonary valve regurgitation typically occurs as a result of pulmonary hypertension (high blood pressure in the pulmonary system) or from a defect in the development of the pulmonary valve before birth (called tetrology of Fallot.) It can also occur due to:
  • An infection, such as rheumatic fever or endocarditis, which may cause scarring on the valve
  • Carcinoid syndrome  (a group of symptoms that occur in patients with a rare type of slow-growing cancer called carcinoid. Carcinoid tumors excrete chemicals into the blood stream that can affect the heart.)
  • In older individuals it may occur as the result of a previous surgery to correct the congenital defect tetralogy of Fallot 

Symptoms