Part UT Health San Antonio

Pulmonary Valve Stenosis—Child

(Pulmonary Stenosis—Child)

by Deanna M. Neff, MPH

Definition

Pulmonary valve stenosis is a problem with a valve in the heart. They valve is thickened or can't open fully. The damaged valve can:

  • Decrease the amount of blood that reaches the lungs. This can decrease the amount of blood that is available to pick up oxygen.
  • Increase the amount of work on the right side of the heart to work.
  • Cause blood to back up into the heart.

For some, it may be a mild condition. Others may have severe problems.

Heart Chambers and Valves
heart anatomy

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Blood Flow Through the Heart

Copyright © Nucleus Medical Media, Inc.

Causes  ^

The valve does not develop as it should. This happens before birth. In most cases, it is not known why this 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

Factors of the mother that may increase the risk of pulmonary valve stenosis in a child include:

  • Previous pregnancy with fetal heart abnormalities or miscarriage
  • Infection with a virus during pregnancy
  • Maternal smoking during pregnancy

Symptoms  ^

Symptoms will depend on how much movement the valve has. They 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

Diagnosis  ^

The doctor will ask about your child’s symptoms and health history. A physical exam will also be done. The doctor may suspect a problem with a heart valve if there is a heart murmur.

Pulmonary stenosis can be confirmed with images from tests such as:

Treatment  ^

Mild stenosis may not need treatment right away. Your child’s care team will monitor your child for any changes or problems.

Moderate or Severe Stenosis

More severe stenosis may need surgery. Surgery may repair or replace the bad valve. It can help to relieve symptoms and prevent heart damage. Common options include:

  • Balloon valvuloplasty —A balloon will be passed to the valve and gently inflated. It will stretch the tissue around the valve. This may only provide temporary relief. The valve may become blocked again.
  • Open heart surgery—To repair valves that cannot be opened with less invasive options.
  • Valve replacement—The valve is replaced with a mechanical or tissue valve.

Complication Prevention

Some health habits can decrease the risk of complications. Steps include:

  • Get regular medical care. This includes basic checkups and heart tests.
  • Talk to your doctor and dentist about antibiotics before any dental procedures. It can help to prevent an infection of the valve. Not everyone with valve stenosis will need this step.
  • Follow a heart healthy lifestyle that includes:
    • Heart healthy diet with plenty of fruits and vegetable and whole grains
    • Aim for a health weight
    • Regular physical activity—may need to limit to low intensity; check with the doctor
  • Monitor blood pressure at home—let the doctor know if your child has high blood pressure readings

Prevention  ^

It is not always clear why heart defects happen. As a result, prevention steps are not clear.

Good prenatal care can reduce the risk of some heart defects. To reduce the risk for a fetus:

  • Visit your care team throughout the pregnancy. Certain tests may show a heart defect in a growing fetus.
  • Practice healthy habits during the pregnancy. This includes healthy eating and prenatal vitamins.
  • Do not drink alcohol, smoke, or use drugs during pregnancy.
RESOURCES:

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

Family Doctor—American Family Physician
http://familydoctor.org

CANADIAN RESOURCES:

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

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

REFERENCES:

Pulmonary stenosis. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=pulmonarystenosis3. Updated January 24, 2017. Accessed December 27, 2017.

Pulmonary stenosis. Lucile Packard Children’s Hospital at Stanford website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/cardiac/ps.html. Accessed December 27 2017.

Pulmonary valve stenosis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Pulmonary-Valve-Stenosis_UCM_307034_Article.jsp. Updated October 13, 2017. Accessed December 27, 2017.

Last reviewed December 2017 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 5/9/2018