Pulmonary Stenosis

• Incidence : 8-10%

• Anatomy:
Pulmonary stenosis valvular :
 Bicuspid pulmonary valve
 Valve leaflet thickening and adhession
Pulmonary stenosis infundibular :
 Hyperthropy infundibulum
 Pulmonary Stenosis

• Clinical findings
Valvular stenosis
Mild : Ejection systolic
Wide 2nd HS
ejectiin click
Moderate: ejection systolic, early systolic click
Severe : ejecstion systolic, ejection click (-)
Stenosis infundibular
Ejection click ( - )
1st HS normal, 2nd HS weak, ejection systolic
Pulmonary stenosis periphery
1st & 2nd HS normal, ejection systolic
 Pulmonary Stenosis

Mild : ejection systolic

2nd HS wide split
ejection click
Moderate: ejecsi systolic , early ejection click
Severe : ejection systolic, click ejection (-)
 Poulmonary Stenosis

• Diagnosis
Asymptomatic patient:
click systolic (stenosis valvular)
systolic murmur
wide split 2nd HS vary with respiration
 Poulmonary Stenosis

Normal or mild cardiomegaly

Marked pulmonary valve
post stenotic dilatation
Normal pulmonary
vascularity
 Pulmonary Stenosis

ECG : RAD
Echocardiograhhy : confirmation diagnosis
Catheterization: increased RV pressure without
increased oxygen saturation
 Pulmonary Stenosis

• Management

Medicamentosa : useless
Mild stenosis: intervention (-)
Moderate stenosis: observation
Severe stenosis: balloon valvuloplasty
Pulmonary Stenosis
 Pulmonary Stenosis

Before ballooning
 Pulmonary Stenosis

During ballooning
 Pulmonary Stenosis

After ballooning