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PULMONARY-VALVE STENOSIS

DESCRIPTION

Pulmonary-valve stenosis is narrowing of the pulmonary valve. The pulmonary valve separates the right ventricle (major chamber) of the heart from the pulmonary artery (the large artery that goes from the heart to the lungs). When this valve becomes narrowed, heart function is impaired. Special parts of the right side of the heart are involved.
Appropriate health care includes:
  • Self-care after diagnosis.
  • Physician's monitoring of general condition and medications.
  • Surgery (only if the defective valve must be repaired).

    SIGNS & SYMPTOMS
    Early stages:

  • No symptoms. Later stages:
  • Chest pain.
  • Dizziness.
  • Faintness upon exertion.
  • Congestive heart failure, with the following symptoms: -- Fatigue. -- Swelling in the lower parts of the child's body--the feet if standing or sitting and the back if lying down. -- Breathlessness with exertion--walking or climbing stairs. -- Later, breathlessness appears without exertion--sometimes even after going to sleep. -- Cough, sometimes with frothy or bloody sputum. -- Nausea and loss of appetite.

    CAUSES

  • Congenital (present at birth).
  • Complication of rheumatic fever (rare).

    RISK FACTORS
    Prior streptococcal infection.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Obtain a throat culture and prompt medical treatment for strep infections to prevent rheumatic fever.
  • If your child has had rheumatic fever, give the child prescribed antibiotics before any surgery, even dental procedures.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies such as EKG, cardiac catheterization, and echocardiography (See Glossary for all).
  • X-rays of the heart and lungs.

    POSSIBLE COMPLICATIONS

    Congestive heart failure.

    PROBABLE OUTCOME
    Mild pulmonary-valve stenosis may cause your child little if any disability. Severe impairment is usually curable with surgery to stretch the defective pulmonary heart valve.

    TREATMENT

    HOME CARE

  • Weigh your child daily and keep a record.
  • Advise any doctor or dentist who treats your child that the child has a disease of the heart valves.

    MEDICATION

  • Your doctor may prescribe diuretics for your child to reduce the fluid retention of congestive heart failure.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    If surgery is not advised and your child's condition allows, normal activity should be continued. The child should avoid strenuous activity but should not be treated as an invalid -- even if there is some disability. Walks and other light exercise may be possible.

    DIET & FLUIDS
    Low-salt diet (See Appendix 29).

    OK TO GO TO SCHOOL?

    When strength and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of pulmonary-valve stenosis.
  • The following occurs during treatment: -- Unexplained weight gain of 3 to 4 pounds in 2 to 3 days, indicating fluid retention. -- Increased breathlessness. -- Wheezing at night. -- Fever. -- Rapid heartbeat. -- Cough. ‡
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