Pulmonary Valve Stenosis – Symptoms and Causes
Overview
Pulmonary stenosis happens when the valve between the right lower heart chamber and lung arteries becomes narrow.
This narrowing makes it harder for blood to flow properly through the valve. When the valve flaps become thick or stiff, blood flow slows down.
As stenosis worsens, the right ventricle (lower right heart chamber) must work harder to push blood to the lungs. This extra strain causes the right ventricle walls to thicken over time.
Most cases of pulmonary stenosis develop before birth as a congenital heart defect. In some adults, the condition might appear as a complication of another illness.
The severity of pulmonary stenosis varies from mild to severe:
- Mild Cases: Often have no symptoms and may only need occasional checkups.
- Moderate To Severe Cases: Usually require medical intervention.
Treatment options for more serious cases include procedures to either repair the damaged valve or replace it completely.
Signs and Symptoms
People with pulmonary valve stenosis may experience different symptoms based on how severe the blockage is. Those with mild cases often have no symptoms at all.
Common signs of pulmonary valve stenosis include:
- Heart murmur (a whooshing sound doctors can hear with a stethoscope)
- Feeling tired or fatigued
- Difficulty breathing, particularly during physical activity
- Pain in the chest
- Passing out or fainting
More severe symptoms appear during exercise or physical activity. In infants with this condition, the skin might appear bluish or grayish because the body isn’t getting enough oxygen.
When to See a Doctor
Contact your healthcare provider right away if you notice:
- Shortness of Breath
- Chest Pain
- Fainting Episodes
These symptoms could indicate pulmonary valve stenosis or other heart issues. Getting diagnosed and treated early can lower the risk of complications.
Causes
Pulmonary valve stenosis typically begins before birth as a congenital heart condition. Doctors aren’t completely sure why this happens. While a baby develops in the womb, the pulmonary valve doesn’t form correctly.
A normal pulmonary valve has three thin tissue flaps (cusps) that open and close with each heartbeat. These cusps ensure blood flows in the proper direction through the heart.
When pulmonary valve stenosis occurs, these problems may develop:
- One or more cusps become thickened or stiff
- Cusps may fuse together
- The valve cannot open fully
This narrowed opening creates difficulties for blood trying to exit the lower right heart chamber. As a result:
- Pressure builds up inside the chamber.
- The heart experiences increased strain.
- Over time, the wall of the lower right heart chamber thickens.
This thickening represents the heart’s attempt to work harder against the resistance created by the narrowed valve.
Risk Factors
Several factors may raise your chance of developing pulmonary valve stenosis:
Pregnancy Exposure to German Measles (Rubella)
- Getting rubella while pregnant increases the risk of pulmonary valve problems in the baby
Genetic Factors
- Noonan syndrome, caused by genetic changes, often leads to heart structure and function issues including pulmonary valve problems
Past Infections
- Rheumatic fever, a strep throat complication, can damage heart valves and increase pulmonary valve stenosis risk later in life
Medical Conditions
- Carcinoid syndrome, which happens when rare cancerous tumors release chemicals into the blood, can sometimes lead to heart valve damage
- People with this condition may develop carcinoid heart disease affecting the pulmonary valve
These risk factors don’t guarantee you’ll develop the condition, but they do increase the likelihood compared to people without these factors.
Complications
Pulmonary stenosis can lead to several health problems if left untreated. One such problem is an infection of the heart’s inner lining, known as infective endocarditis. People with this valve condition face higher risks of developing such bacterial infections.
Heart rhythm problems, or arrhythmias, occur more frequently in individuals with pulmonary stenosis. These irregular heartbeats are usually not life-threatening unless the stenosis is severe.
When pulmonary stenosis becomes severe, the heart muscle may thicken. This happens because the lower right heart chamber (right ventricle) must work harder to push blood through the narrowed valve. This condition is called right ventricular hypertrophy.
Heart failure can develop if the right ventricle cannot pump effectively. Signs include:
- Feeling very tired
- Trouble breathing
- Swelling in the legs and stomach area
Pregnancy can be more challenging for those with severe pulmonary valve stenosis. These individuals face higher risks of complications during labor and delivery compared to those without the condition.
