Internal Medicine

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:19

1250 Pulmonary Stenosis (PS) Pulmonary Valve Insufficiency (PI)

differential diagnosis

■Aortic stenosis

■Pulmonary artery stenosis

management

Medical Treatment

■Antiboitic prophylaxis

specific therapy

■Balloon valvulotomy

➣Asymptomatic patients with gradient >75 mm Hg

➣Symptomatic patients with gradient >50 mm Hg

follow-up

n/a

complications and prognosis

Complications

■Right ventricular failure with tricuspid valve insufficiency

■Right to left atrial shunt through patent foramen ovale

Prognosis

■Overall prognosis good, unless severe right ventricular failure

PULMONARY VALVE INSUFFICIENCY (PI)

JUDITH A. WISNESKI, MD

history & physical

Etiology

■Pulmonary artery hypertension (most common)

■Idiopathic dilation of pulmonary artery

■Connective tissue disorders

■Congenital

History

■Symptoms of right ventricular failure and low cardiac output

Signs & Symptoms

■High pitched decrescendo or low pitched diastolic murmur left ster-

nal border

■Right ventricular lift