(Pulmonary Stenosis—Child)
Definition
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
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
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
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
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
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.
Prevention
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:
Family Doctor—American Family Physician http://familydoctor.org
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada http://www.heartandstroke.com
References:
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_UCM_307034_Article.jsp
Updated June 24, 2013. Accessed November 7, 2014.
Last Updated: 12/20/2014