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.
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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

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done. A heart valve problem may be suspected if there is a heart murmur.Images of your child's heart and its structures may be taken. This can be done with:

Treatment

If your child has mild pulmonary valve stenosis, immediate treatment may not be needed. Your child will be monitored 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 advised. 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 dietitian 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 .

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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 healthcare provider 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 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.com

References

Pulmonary stenosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 14, 2014. Accessed November 7, 2014.

Pulmonary stenosis. Johns Hopkins University, Cove Point Foundation website. Available at: http://www.pted.org/?id=pulmonarystenosis3. Updated October 24, 2011. Accessed November 7, 2014.

Pulmonary stenosis. Lucile Packard Children’s Hospital at Stanford website. Available at: http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/cardiac/ps.html. Accessed November 7, 2014.

Pulmonary valve stenosis. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Pulmonary-Valve-Stenosis%5FUCM%5F307034%5FArticle.jsp. Updated June 24, 2013. Accessed November 7, 2014.

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