Pathology: Incompetent pulmonary valveallowing backflow of blood into right ventricle
Aetiology: Pulmonary hypertension,infective endocarditis, carcinoid, post pulmonary valve
Surgery, connective tissue disease, Tetralogyof Fallot
Symptoms: Usuallyasymptomatic or symptoms of right heart failure
Signs: Rightventricular heave, raised JVP, Loud and delayed P2 heart sound. Graham Steellmurmur
Investigations: ECG: Right ventricular hypertrophy andright bundle branch block
Chest X-Ray: Large pulmonary trunk
Echo: Enlarged right ventricle with reducedfunction, may show tricuspid regurgitation
Treatment: Medical: Salt restriction and treat pulmonary hypertension
Surgical: Valvereplacement or percutaneous pulmonary valve implantation
Complications: Heart failure, valve failure, infectiveendocarditis and thromboembolic events
Prognosis: Surgery improves outcome
