Pathology: Narrowing of pulmonary valvecausing a decreased outflow and increased back
pressure in the right ventricle
Aetiology: Carcinoid, rheumatic fever, congenital(Noonan Syndrome)
Symptoms: Dyspnoea
Signs: Rightventricular heave, raised JVP, prominent ‘a’ waves, Split second heart sound
Investigations: ECG: Right axis deviation and Rightventricular hypertrophy
Chest X-Ray: Post stenotic pulmonaryartery dilatation
Echo: Assesses for structural abnormalities
Treatment: Medical: Salt restriction and diuretics
Surgical: Valvereplacement, Balloon valvuloplasty
Complications: Heart failure, arrhythmias, andinfective endocarditis
Prognosis: Surgery improves outcome, howeverpatients can experience pulmonary
regurgitationfollowing valve surgery
