Presentation
A 63 year-old female presented with dyspnea on exertion. Her chest X-ray showed cardiomegaly, and right ventricular overload and tricuspid regurgitation were detected. [ncbi.nlm.nih.gov]
A heart murmur is the most common sign detected by a physician indicating that a valve problem may be present. [cincinnatichildrens.org]
Significant coronary artery abnormalities were present in 28(4.9%) children. Conclusion Pulmonary artery abnormalities were present in 18.92% of patients with Tetralogy of Fallot. [springerplus.springeropen.com]
A diastolic tail curve was present only in stenosed arteries of patients. [jcmr-online.biomedcentral.com]
Date: 2004 Abstract: This article presents a patient with tetralogy of Fallot who developed bilateral branch pulmonary artery stenosis following surgical repair that was refractory to balloon dilatation. [um.edu.mt]
Entire Body System
- Pulmonary Valve Stenosis
The pulmonary valve is located between the right ventricle and the pulmonary artery. The valve acts as a doorway that lets blood into and out of the heart. Pulmonary valve stenosis is when the pulmonary valve does not open properly or wide enough. [healthline.com]
Areas of potential narrowing include thickened muscle below the pulmonary valve, stenosis of the valve itself, or stenosis of the pulmonary artery above the valve. [cincinnatichildrens.org]
It should not be confused with a pulmonary valve stenosis, which is in the heart, but can have similar hemodynamic effects. Both stenosis of the pulmonary artery and pulmonary valve stenosis are causes of pulmonic stenosis. [en.wikipedia.org]
stenosis, Narrowing of pulmonary valve, PS Overview Pulmonary valve stenosis accounts for 8% of all congenital heart disease and worldwide the prevalence of pulmonary valve stenosis is 1 per 2000 births. [1] The pulmonic valve stenosis is classified [wikidoc.org]
[…] and onward to the lungs Truncus arteriosus – the formation of only one combined artery instead of the normal two outlets from the heart, the aorta and pulmonary artery Pulmonary valve stenosis – problems with the pulmonary valve (for example, development [my.clevelandclinic.org]
- Surgical Procedure
Abstract Obliterating thrombosis of the pulmonary artery or its main branches is a relatively uncommon condition if those cases which occur as a complication of surgical procedures or the puerperal state are excluded. [annals.org]
procedures used to correct other heart defects (for example, pulmonary artery banding - a purposeful narrowing of the artery to reduce blood flow to the lungs). [my.clevelandclinic.org]
Open-heart surgical procedures are required for more complex valves, where balloon dilation is not sufficient therapy. [cincinnatichildrens.org]
Examples of these medications include: prostaglandins to improve blood flow blood thinners to reduce clotting water pills to reduce excess fluid in the blood stream pills that prevent irregular heart rhythms A surgical procedure known as a valvuloplasty [healthline.com]
Description of a sutureless surgical procedure using the pericardium in situ. Arch Mal Coeur Vaiss 1996;89:633-6. [ PubMed ] Najm HK, Caldarone CA, Smallhorn J, et al. [tp.amegroups.com]
- Atrial Septal Defect
With severe PS and decreased right ventricular chamber compliance, cyanosis can occur from right-to-left shunting if a concomitant patent foramen ovale, atrial septal defect, or ventricular septal defect is present. [emedicine.medscape.com]
It can occur in children with otherwise normal hearts or along with other congenital heart defects such as atrial septal defect or Tetralogy of Fallot. [mottchildren.org]
The echocardiogram is also important to exclude other problems that may be associated with pulmonary stenosis, such as an atrial septal defect (ASD) or ventricular septal defect (VSD). [cincinnatichildrens.org]
Significant associated cardiac lesions including Patent Ductus Arteriosus, additional muscular Ventricular Septal Defect, coronary artery abnormalities, bilateral Superior Vena Cava, Atrial Septal Defect and Major Aortopulmonary Collateral Arteries were [springerplus.springeropen.com]
defect - Atrial septal defect ( Lutembacher's syndrome ) - Atrioventricular septal defect ( Ostium primum ) - Tetralogy of Fallot - Eisenmenger's syndrome Right: pulmonary and tricuspid valves pulmonary valves ( stenosis, insufficiency ) - tricuspid [wikidoc.org]
- Asymptomatic
Patients with supravalvular PS may be asymptomatic or have symptoms of dyspnea and fatigue on exertion. Physical Examination The common examination findings include: Patients with isolated pulmonary stenosis usually appear normal. [wikidoc.org]
[…] location of maximum intensity dependent on exact location of stenosis within arteries) Wide, fixed splitting of S2 may be associated with other underlying pathology Pulmonic Stenosis Differential Even after differentiated from other possible causes of asymptomatic [pedclerk.bsd.uchicago.edu]
Clinical features Pts. with mild or moderate bilateral PA stenosis, as well as those with unilateral stenosis, are usually asymptomatic DOE, easy fatigability, and signs of right heart failure may occur in patients with severe obstruction. Children [slideshare.net]
Children with pulmonary valvar stenosis are usually asymptomatic and in normal health. A heart murmur is the most common sign detected by a physician indicating that a valve problem may be present. [cincinnatichildrens.org]
In the above cited national study reevaluated 15 to 25 years later, the probability of 25-year survival was 95.6% compared with an expected age- and sex-matched control group survival of 96.6%.97% were asymptomatic. [rjmatthewsmd.com]
Respiratoric
- Dyspnea
A 63 year-old female presented with dyspnea on exertion. Her chest X-ray showed cardiomegaly, and right ventricular overload and tricuspid regurgitation were detected. [ncbi.nlm.nih.gov]
These symptoms include: exercise intolerance, fatigue, dyspnea, presyncope or syncope, symptoms of right-sided congestive heart failure, chest pain from RV ischemia or symptoms related to arrhythmias. [heartdiseaseandpregnancy.com]
Moderate Pulmonic Stenosis: Patients present with exertional dyspnea and fatigue. Severe Pulmonic Stenosis: Patients present with exertional dyspnea, chest pain and syncope. [wikidoc.org]
Signs and symptoms include dyspnea, tachypnea, tachycardia, fatigue, and edema. [icd10data.com]
Alarming symptoms include anginal chest pain, syncope, and dyspnea on exertion. When these occur, surgery to repair or replace the diseased valve are necessary. [medical-dictionary.thefreedictionary.com]
Cardiovascular
- Heart Murmur
Pulmonary valve stenosis can cause a heart murmur. A heart murmur sounds like an extra click, blowing, whooshing, or rasping sound when a doctor listens to your heart. The murmur can be an initial indicator of pulmonary valve stenosis. [healthline.com]
The first sign of the condition often is a heart murmur, an extra sound heard during a chest examination. [ucsfbenioffchildrens.org]
The diagnosis of pulmonary stenosis is usually first suspected because a physician detects a heart murmur. The heart murmur of pulmonary stenosis is a turbulent noise caused by ejection of blood through the obstructed valve. [cincinnatichildrens.org]
Sapin SO (1997).Recognizing normal heart murmurs: a logic-based mnemonic. Pediatrics, 99, 616. Silberbach M and Hannon D (2007).Presentation of congenital heart disease in the neonate and young infant. Pediatrics in Review, 28(4), 123-130. [pedclerk.bsd.uchicago.edu]
- Cyanosis
With severe PS and decreased right ventricular chamber compliance, cyanosis can occur from right-to-left shunting if a concomitant patent foramen ovale, atrial septal defect, or ventricular septal defect is present. [emedicine.medscape.com]
If the condition is severe, symptoms may include: Episodes of pain in the chest causing difficulty breathing Low energy Poor feeding Rapid breathing Tiring early with exercise Turning blue, a condition called cyanosis Because there may be no obvious symptoms [ucsfbenioffchildrens.org]
A lack of blood to your tissues can lead to cyanosis, which causes your skin to turn blue and affects your breathing. Any structural defect in the heart can increase the risk of an infection inside the heart. [healthline.com]
Critical pulmonary stenosis in the newborn can cause blueness of the lips (a condition called cyanosis) and/or congestive heart failure. Physical findings: The diagnosis is most often made due to the presence of a heart murmur. [mottchildren.org]
Newborns with critical pulmonary stenosis therefore will have cyanosis (blue discoloration of the lips and nail beds) due to lower oxygen levels in their blood. [cincinnatichildrens.org]
- Hypertension
[…] but is likely misdiagnosed as either idiopathic pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. [jcecho.org]
There was evidence of severe pulmonary hypertension. [heartindia.net]
Her pulmonary ventilation and blood flow scintigraphy findings were suspicious of pulmonary vascular disease; the diagnosis was pulmonary hypertension and bilateral branch pulmonary artery stenosis. [ncbi.nlm.nih.gov]
[…] disorder 心身症 PSD psychosomatic medicine 心身医学 PSM psychostimulant 精神刺激薬 psychotherapy 精神療法/心理療法 pubarche 恥毛発現/恥毛発来/陰毛発現/陰毛発来 puberty 思春期 pubic hair 陰毛 pubic louse ケジラミ pulmonary actinomycosis 肺放線菌症/肺アクチノミセス症 pulmonary agenesis 肺無形成 pulmonary arterial hypertension [jpeds.or.jp]
- Tachycardia
Sustained ventricular tachycardia in adult patients late after repair of tetralogy of Fallot. [jsachd.org]
Signs and symptoms include dyspnea, tachypnea, tachycardia, fatigue, and edema. [icd10data.com]
[…] branch block ( Left, Right ) - Bifascicular block - Trifascicular block Pre-excitation syndrome ( Wolff-Parkinson-White, Lown-Ganong-Levine ) - Long QT syndrome - Adams-Stokes syndrome - Cardiac arrest - Sudden cardiac death Arrhythmia : Paroxysmal tachycardia [wikidoc.org]
- Ejection Murmur
A systolic ejection murmur of Grade 3/6 intensity was audible in left second intercostal space. Another peculiar finding was a continuous murmur in the back and both axilla. [jcecho.org]
Atrial septal defect : Presence of systolic ejection murmur, wide fixed split S2, EKG showing RVH. In ASD the split of the S2 is fixed, there is no ejection click. [wikidoc.org]
Neurologic
- Seizure
6651 ~ 6700 番を表示 (全 8148 件) 英文 和文 略語 psychologist 心理学者 psychomotor retardation 精神運動発達遅滞 psychomotor seizure 精神運動発作 psychonephrology サイコネフロロジー psychosis 精神病 psychosocial dwarfism【旧】【不適切】 心理社会性低身長【奨】/心理社会性低身長症【奨】/心理社会性小人症 psychosocial short stature 心理社会性低身長 [jpeds.or.jp]
Workup
Hypertrophy
- Ventricular Hypertrophy
Concentric ventricular hypertrophy occurs in response to pressure overload. [pedsinreview.aappublications.org]
With severe valvular PS, subvalvular right ventricular hypertrophy can cause infundibular narrowing and contribute to the right ventricular outflow obstruction. This often regresses after correction of valvular stenosis. [emedicine.medscape.com]
One example is right ventricular hypertrophy, or heart enlargement. This can weaken and permanently damage the heart. It may also cause irregular heartbeats. [healthline.com]
Electrocardiogram and chest X-ray were consistent with right ventricular hypertrophy. [jcecho.org]
The heart's apical impulse may be laterally and inferiorly displaced as a result of left ventricular hypertrophy. Alarming symptoms include anginal chest pain, syncope, and dyspnea on exertion. [medical-dictionary.thefreedictionary.com]
Treatment
Treatment has included surgery, balloon angioplasty, and balloon expandable stent placement. It was the purpose of this investigation to demonstrate the cost-effectiveness of each of these modes of treatment. [ncbi.nlm.nih.gov]
What is the treatment? Treatment is only needed when the narrowing is of a sufficient severity to be a concern. Some people with only mild or moderate narrowing never need any treatment. [childrensheartcentre.com]
Treatment options for pulmonary stenosis include open-heart surgery or balloon angioplasty. The primary indication for treatment is the degree of narrowing and treatment is timed to prevent damage to the right heart. [mottchildren.org]
Others will experience worsening symptoms that will likely require treatment. A doctor may prescribe medications that make it easier for blood to flow through the heart’s chambers. [healthline.com]
Prognosis
What is the prognosis? The prognosis for this condition is generally good, with survival without complications nearly 100%. In the long term, these children fare well and most have no symptoms and lead normal lives. [childrensheartcentre.com]
Prognosis and Management Benign type generally disappears before one year of age. [pedclerk.bsd.uchicago.edu]
This is particularly true in patients with associated syndromes, such as Williams, Noonan, or congenital rubella However, multiple peripheral pulmonary stenosis of severe degree may be progressive, and the prognosis is poor unless angioplasty, stent [slideshare.net]
Patients with moderate to severe pulmonic valve stenosis are managed well with surgery or balloon valvuloplasty and have very good prognosis. [wikidoc.org]
The prognosis of those with severe obstruction without intervention is poor, especially in infants with critical obstruction. [rjmatthewsmd.com]
Etiology
Pulmonary vein stenosis: Etiology, diagnosis and management. World J Cardiol 2016;8:81-8. 4. Seale AN, Daubeney PE, Magee AG, Rigby ML. Pulmonary vein stenosis: Initial experience with cutting balloon angioplasty. Heart 2006;92:815-20. 5. [jcecho.org]
[…] ses ) an abnormal narrowing or contraction of a body passage or opening; called also arctation, coarctation, and stricture. aortic stenosis obstruction to the outflow of blood from the left ventricle into the aorta; in the majority of adult cases the etiology [medical-dictionary.thefreedictionary.com]
Epidemiology
The changing epidemiology of congenital heart disease. Nat Publ Gr. 2010;8:50-60. [ Links ] 3. Lara D, López K. Public health research in congenital heart disease. Congenit Heart Dis. 2014;9:549-58. [ Links ] 4. Calderón J, Ramírez S, Cervantes J. [scielo.org.co]
Genetics These are a common genetic disorders associated with pulmonic stenosis: [9] Associated conditions A rare association of pulmonic stenosis with an unrepaired ASD is reported. [19] Epidemiology and Demographics Pulmonary stenosis accounts for 8% [wikidoc.org]
Pathophysiology
AIMS: The pathophysiology of branch pulmonary artery (PA) stenosis after the arterial switch operation, most commonly on the left, is incompletely understood. This study examines factors associated with left PA (LPA) obstruction. [ncbi.nlm.nih.gov]
We aimed to improve understanding of the nature and possible clinical implications of this pathophysiological finding. [jcmr-online.biomedcentral.com]
Pathophysiology A systolic pressure gradient between the pumping chamber and its downstream artery is the primary hemodynamic abnormality of stenosis regardless of whether the obstruction is right- or left-sided. [pedsinreview.aappublications.org]
[…] doi.org/10.1093/ehjci/jew046 Download citation file: Ris (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager © 2019 Oxford University Press Close Navbar Search Filter Mobile Microsite Search Term Close search filter search input Aims The pathophysiology [academic.oup.com]
[…] main pulmonary artery None or variable and dependent on severity of obstruction According to 2014 AHA/ACC Guidelines for the Management of Patients With Valvular Heart Disease, progression of valvular heart disease (VHD) are defined as follows: [6] Pathophysiology [wikidoc.org]
Prevention
It most commonly occurs after a dental or other medical procedure and can usually be prevented by a dose of antibiotic prior to the procedure. [mottchildren.org]
Several gauze pads and a large piece of medical tape will be placed on the site where the catheter was inserted to prevent bleeding. [stanfordchildrens.org]
Valvotomy - surgical release of adhesions that are preventing the valve leaflets from opening properly. Postoperative care for your child After surgery, your child will go to the intensive care unit (ICU). [chw.org]
A child with peripheral pulmonary stenosis may also need to periodically take antibiotics in order to prevent an infection called bacterial endocarditis. [medicina-interventionala.ro]
[…] ventricular septal defect, 2) a narrowing at or just beneath the pulmonary valve, 3) a right ventricle that is more muscular than normal, 4) an aorta that lies directly over the ventricular septal defect Pulmonary atresia – absence of a pulmonary valve, preventing [my.clevelandclinic.org]