Symptoms of pulmonary valve disease are more often due to the stenosis component and depend on the severity of the condition. They consist of complaints resulting from decreased cardiac output caused by right ventricular dysfunction: dyspnea, fatigability, exertional syncope or dizziness, chest pain, peripheral edema and, in rare cases, sudden death. If a ventricular septal defect coexists, like in tetralogy of Fallot, cyanotic spells may occur. If foramen ovale is patent, right atrial pressure may exceed left atrial pressure, leading to right-to-left shunt and cyanosis [1].

Physical signs also depend on severity. If the stenosis component is mild, it gives rise to a short presystolic murmur and an ejection click that only appears if the valves are pliable, while in severe stenosis the murmur is more intense and becomes holo-systolic and the click disappears because of the right ventricular end-diastolic pressure being higher than the pulmonary arterial pressure. In mild cases, the second heart sound is widely split, while in severe disease patients the pulmonary component becomes inaudible. The pulmonary regurgitation, especially if severe and caused by pulmonary hypertension, causes a high-pitched diastolic murmur that might be misinterpreted as aortic regurgitation. In mild to moderate pulmonary regurgitation situations, the murmur may be absent. If infundibular or supravalvular stenosis coexists, the systolic murmur changes accordingly: it peaks later during the systole or becomes more prolonged. If the right ventricle is enlarged, in can be palpated in the epigastric region (Hartzer sign). The jugular pulse may have a prominent "A" wave. If the pulmonary regurgitation component is severe, the heart may be enlarged, pulsatile and painful [2].

• Pulmonary Valve Stenosis

  Symptoms of pulmonary valve stenosis Mild cases of pulmonary valve stenosis often cause no symptoms. [wexnermedical.osu.edu]

  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]

  Both stenosis of the pulmonary artery and pulmonary valve stenosis are forms of pulmonic stenosis (nonvalvular and valvular, respectively) [5] but pulmonary valve stenosis accounts for 80% of pulmonic stenosis. [en.wikipedia.org]

  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]

  What is pulmonary valve stenosis? Pulmonary valve stenosis is the term describing a narrowing in the opening of the pulmonary valve. [childrenshospital.org]

• Pain

  They consist of complaints resulting from decreased cardiac output caused by right ventricular dysfunction: dyspnea, fatigability, exertional syncope or dizziness, chest pain, peripheral edema and, in rare cases, sudden death. [symptoma.com]

  Symptoms of Pulmonary Regurgitation Symptoms may include: Difficulty breathing and fatigue, especially during exercise Chest pain, such as squeezing, pressure or tightness Sensation of rapid or irregular heartbeat (palpitations) Swelling of the legs or [heart.uvahealth.com]

  If left untreated and in advanced stages, pulmonary stenosis may lead to: Low tolerance for exercise Shortness of breath or skin turns blue around the lips Listlessness Inability to gain weight Chest pain Fatigue Dignity Health Central California offers [dignityhealth.org]

  Seek medical treatment if you experience chest pain, shortness of breath, or fainting as a result of your pulmonary valve stenosis. These symptoms can indicate your condition is advancing. Mild stenosis may improve with time. [healthline.com]

• Fatigue

  Symptoms of Pulmonary Regurgitation Symptoms may include: Difficulty breathing and fatigue, especially during exercise Chest pain, such as squeezing, pressure or tightness Sensation of rapid or irregular heartbeat (palpitations) Swelling of the legs or [heart.uvahealth.com]

  This results in fatigue or shortness of breath. [beaumont.org]

  If left untreated and in advanced stages, pulmonary stenosis may lead to: Low tolerance for exercise Shortness of breath or skin turns blue around the lips Listlessness Inability to gain weight Chest pain Fatigue Dignity Health Central California offers [dignityhealth.org]

  Symptoms of a disease are indications that can be detected by the patient, such as pain or fatigue (while signs are indications that can be detected by a doctor, such as the results of a blood test or an X-ray). [dartmouth-hitchcock.org]

• Surgical Procedure

  A few surgical procedures include: Cardiac catheterization: A surgical procedure that involves the insertion of a tube into a vein in the leg and up to the heart and further insertion of instruments through the tube to help diagnose and treat cardiovascular [humanitas.net]

  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]

  While transcatheter procedures were associated with shorter hospital stay, there was no difference in hospital costs. [acc.org]

  The American Heart Association no longer recommends taking routine antibiotics before certain dental or surgical procedures except for people at the highest risk for bad outcomes if they do develop endocarditis. [ihimontanafoundation.org]

  Open-heart surgical procedures are required for more complex valves, where balloon dilation is not sufficient therapy. [cincinnatichildrens.org]

• Congestive Heart Failure

  The most common cause is pulmonary hypertension or left side congestive heart failure. This results in fatigue, swelling of abdomen, liver and legs. [beaumont.org]

  In mild cases there may be no symptoms, while in advanced cases, valvular heart disease may lead to congestive heart failure and other complications. Treatment depends upon the extent of the disease. [hopkinsmedicine.org]

  Valve replacement for aortic stenosis with severe congestive heart failure and pulmonary hypertension. J Heart Valve Dis 1996; 5:268–272 PubMed Google Scholar 6. Lanzarini L, Fontana A, Lucca E, et al. [link.springer.com]

  Some people with pulmonary valve disorders experience few or no symptoms, but if the condition is not treated it can result in serious complications, including congestive heart failure or a condition called cardiomyopathy, in which the heart muscle becomes [dartmouth-hitchcock.org]

  Congestive heart failure, acute pulmonary edema, and RV heart failure are the predominant causes of death. [imaging.onlinejacc.org]

• Dyspnea

  […] while laying flat) or paroxysmal nocturnal dyspnea (PND). [healio.com]

  They consist of complaints resulting from decreased cardiac output caused by right ventricular dysfunction: dyspnea, fatigability, exertional syncope or dizziness, chest pain, peripheral edema and, in rare cases, sudden death. [symptoma.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]

  Symptoms and signs [ edit ] Among some of the symptoms consistent with pulmonary valve stenosis are the following: [6] Heart murmur Cyanosis Dyspnea Dizziness Upper thorax pain Developmental disorders Cause [ edit ] In regards to the cause of pulmonary [en.wikipedia.org]

  […] on exertion, orthopnea, fatigue, and occasionally paroxysmal nocturnal dyspnea. [textbookofcardiology.org]

• Exertional Dyspnea

  Moderate Pulmonic Stenosis: Patients present with exertional dyspnea and fatigue. Severe Pulmonic Stenosis: Patients present with exertional dyspnea, chest pain and syncope. [wikidoc.org]

  Although asymptomatic at rest, patients with VHD and exercise PH often develop exertion dyspnea and became rapidly symptomatic during follow-up. Conversely, exercise systolic PAP provides useful information on individual patient outcome (10,11). [imaging.onlinejacc.org]

  […] on exertion, orthopnea, fatigue, and occasionally paroxysmal nocturnal dyspnea. [textbookofcardiology.org]

• Tachypnea

  Other symptoms of acute aortic regurgitation are tachypnea, tachycardia and rapidly progressive pulmonary edema and/or cardiogenic shock. [textbookofcardiology.org]

• Regurgitation

  The pulmonary regurgitation, especially if severe and caused by pulmonary hypertension, causes a high-pitched diastolic murmur that might be misinterpreted as aortic regurgitation. [symptoma.com]

  Severe tricuspid regurgitation usually requires surgery to be performed in association with mitral valve surgery. Mild-to-moderate tricuspid regurgitation requires surgery when annular dilatation or severe pulmonary hypertension is present. [ncbi.nlm.nih.gov]

  […] feet Dizziness or fainting Bluish discoloration of the nails and lips (cyanosis) Diagnosing Pulmonary Regurgitation Your doctor may discover pulmonary regurgitation by the following: Abnormal chest sounds, such as a heart murmur Distention of the jugular [heart.uvahealth.com]

  Pulmonary regurgitation Pulmonary regurgitation occurs only very rarely as a congenital anomaly. [patient.info]

• Hypertension

  Echocardiography provides information on heart chamber dimensions, right ventricular function, and the degree of pulmonary hypertension. [ncbi.nlm.nih.gov]

  The most common causes for a leaky pulmonary valve is pulmonary hypertension or a congenital heart defect (most specifically, a defect called tetralogy of Fallot ). [heart.org]

  Significant pulmonary regurgitation may also be caused by primary pulmonary hypertension, secondary pulmonary hypertension, infective endocarditis (rare, but may occur in an intravenous drug user or with an atrial septal defect and a large left-to-right [patient.info]

  Palpable signs are attributable to pulmonary hypertension and RV hypertrophy. [merckmanuals.com]

  Expert Consensus Document on Pulmonary Hypertension. [hipertension-pulmonar.org]

• Heart Murmur

  The main sign of heart valve disease is an unusual heartbeat sound called a heart murmur. Your doctor can hear a heart murmur with a stethoscope. But many people have heart murmurs without having a problem. [icdlist.com]

  Diagnosis Heart valve disease is diagnosed by listening to the heart with a stethoscope; diseased heart valves make distinct clicking sounds or murmurs. [ihimontanafoundation.org]

  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]

  How Ohio State diagnoses pulmonary valve stenosis Pulmonary valve stenosis is often diagnosed when a physician hears an abnormal sound, such as a heart murmur, through a stethoscope during a routine examination. [wexnermedical.osu.edu]

  Presentation See also the separate Heart Auscultation and Heart Murmurs in Children articles. Pulmonary regurgitation is usually asymptomatic unless severe, when it may lead to signs of right heart failure. [patient.info]

• Chest Pain

  Symptoms of Pulmonary Regurgitation Symptoms may include: Difficulty breathing and fatigue, especially during exercise Chest pain, such as squeezing, pressure or tightness Sensation of rapid or irregular heartbeat (palpitations) Swelling of the legs or [heart.uvahealth.com]

  They consist of complaints resulting from decreased cardiac output caused by right ventricular dysfunction: dyspnea, fatigability, exertional syncope or dizziness, chest pain, peripheral edema and, in rare cases, sudden death. [symptoma.com]

  If left untreated and in advanced stages, pulmonary stenosis may lead to: Low tolerance for exercise Shortness of breath or skin turns blue around the lips Listlessness Inability to gain weight Chest pain Fatigue Dignity Health Central California offers [dignityhealth.org]

  Seek medical treatment if you experience chest pain, shortness of breath, or fainting as a result of your pulmonary valve stenosis. These symptoms can indicate your condition is advancing. Mild stenosis may improve with time. [healthline.com]

• Cyanosis

  The skin will have a blue appearance (cyanosis), because the body's blood contains a low amount of oxygen. Absent pulmonary valve also results in very enlarged (dilated) branch pulmonary arteries (the arteries that carry blood to the lungs). [mostellarmedical.org]

  […] breathing and fatigue, especially during exercise Chest pain, such as squeezing, pressure or tightness Sensation of rapid or irregular heartbeat (palpitations) Swelling of the legs or feet Dizziness or fainting Bluish discoloration of the nails and lips (cyanosis [heart.uvahealth.com]

  The baby will begin to breathe quickly, have a rapid heartbeat and be bluish-grey in color (due to cyanosis) because of low levels of oxygen in the blood in the body Individuals with congenital heart defects will need to be followed long-term by a cardiologist [health.state.mn.us]

  If foramen ovale is patent, right atrial pressure may exceed left atrial pressure, leading to right-to-left shunt and cyanosis. Physical signs also depend on severity. [symptoma.com]

  Critical PS causes cyanosis and is potentially lethal in the neonate. [patient.info]

• Diastolic Murmur

  The pulmonary regurgitation, especially if severe and caused by pulmonary hypertension, causes a high-pitched diastolic murmur that might be misinterpreted as aortic regurgitation. [symptoma.com]

  murmur starts at S2--> descrendo (high pitch) signs of aortic regurg Corrigan's pulse Rapid forceful carotid upstroke followed by rapid decline signs of aortic regurg Quincke's pulse Diastolic blanching in nail bed when slightly compressed signs of aortic [brainscape.com]

  Soft diastolic murmur at the left upper sternal edge. Right ventricular hypertrophy. Loud P2 (pulmonary component of the second heart sound). May be differentiated from aortic regurgitation by lack of collapsing pulse. Investigations ECG. CXR. [patient.info]

  High-pitched, early diastolic decrescendo murmur On auscultation, the 1st heart sound (S 1 ) is normal. The S 2 may be split or single. [merckmanuals.com]

  An apical diastolic thrill can be palpated. A holodiastolic murmur can be auscultated at the apex with a presystolic accentuation in sinus rhythm. The intensity of this murmur is determined by the transmitral gradient. [textbookofcardiology.org]

• Prolapse

  Pulmonary valve prolapse and regurgitation are most often caused by pulmonary hypertension (high blood pressure in the lungs, often as a result of chronic obstructive pulmonary disease). [dartmouth-hitchcock.org]

  If they don't, you could have Regurgitation - when blood leaks back through the valve in the wrong direction Mitral valve prolapse - when one of the valves, the mitral valve, has "floppy" flaps and doesn't close tightly. [icdlist.com]

  TV prolapse is seen in nearly 30% of patients with mitral valve prolapse. [revespcardiol.org]

  These changes may be brought on by: Rheumatic fever (usually strep throat) Endocarditis Mitral valve prolapse Coronary artery disease Heart attack Syphilis Hypertension Aortic aneurysms Less common causes of pulmonary valve disease include the following [humanitas.net]

  In the United States, backflow is most often due to prolapse. "Prolapse" is when the flaps of the valve flop or bulge back into an upper heart chamber during a heartbeat. [medicine.umich.edu]

• Suggestibility

  suggesting moderate to severe stenosis and a pulmonary diastolic pressure of 9 mmHg (PR velocity - 1.51 m/s) on Doppler-echocardiography which is similar to catheter-based pressure in the pulmonary veins (PCWP = LA pressure) suggest an isolated pulmonary [file.scirp.org]

  These haemodynamic findings are similar to recent studies in bicuspid aortic disease, and suggest the importance of flow patterns in the pathophysiology of vessel dilation in both aortic and pulmonary bicuspid valve disease. [rdm.ox.ac.uk]

  Still, it is important to measure pulmonary artery pressure: systolic, mean and diastolic; the fact that systolic pulmonary artery pressure may be as high as or exceed the systemic pressure is also suggested by an immobile or abnormal motion interventricular [symptoma.com]

  A peak tricuspid E-wave velocity >1 m/s by pulsed-wave Doppler in the absence of tricuspid stenosis or systolic hepatic flow reversal is also suggestive of severe TR. [imaging.onlinejacc.org]

  A narrow jet width at the origin suggests lower degrees of regurgitation, while a wide jet, particularly with a core of high signal from laminar flow, suggests more severe regurgitation. [jcmr-online.biomedcentral.com]

• Dizziness

  […] of Pulmonary Regurgitation Symptoms may include: Difficulty breathing and fatigue, especially during exercise Chest pain, such as squeezing, pressure or tightness Sensation of rapid or irregular heartbeat (palpitations) Swelling of the legs or feet Dizziness [heart.uvahealth.com]

  They consist of complaints resulting from decreased cardiac output caused by right ventricular dysfunction: dyspnea, fatigability, exertional syncope or dizziness, chest pain, peripheral edema and, in rare cases, sudden death. [symptoma.com]

  If and only if Pulmonic Stenosis is severe, those who suffer from it may develop shortness of breath, chest discomfort and/or dizziness and fainting. [hcmw.com]

  However, when symptoms do develop, many of them are similar to those associated with heart failure: Shortness of breath, especially with exercise Palpitations Chest pain (may be mild) Fatigue Dizziness or fainting Bluish nails, lips or skin Heart murmur [houstonmethodist.org]

  Symptoms Common signs and symptoms of pulmonary valve disease include the following: Tiredness Dizziness Shortness of breath Discomfort in the chest Heart palpitations Swelling of the ankles, feet or abdomen Weight gain Symptoms do not always relate to [humanitas.net]

Brain natriuretic peptide is measured initially and at follow-up visits, as it is a good indicator of disease evolution [3]. The electrocardiogram shows right ventricular hypertrophy and right atrial dilatation, while posteroanterior and lateral chest radiography highlights a dilated pulmonary trunk and diminished pulmonary vascularization.

More information is added by echocardiography with regard to both stenosis and regurgitation components. The physician should assess valvular morphology, as well as supplementary supravalvular and subvalvular stenosis. Color doppler helps quantify the severity of the stenosis in a qualitative manner and assess the number of regurgitant flows, while pulsed and continuous wave doppler measure jet velocity and pressure gradients [4]. Flow velocities of regurgitant jets should be measured, as well as jet acceleration time. Planimetry is not feasible, and continuity equation and proximal isovelocity surface area methods are not validated for pulmonary valve disease. Still, it is important to measure pulmonary artery pressure: systolic, mean and diastolic [5]; the fact that systolic pulmonary artery pressure may be as high as or exceed the systemic pressure is also suggested by an immobile or abnormal motion interventricular septum. Right ventricular enlargement should also be quantified [6].

Computer tomography and magnetic resonance imaging are also useful in assessing disease severity and the cardiac status [7]. Cardiac catheterization is not usually needed in this condition unless echocardiographic and clinical findings are very different. It can more reliable to assess right ventricular and pulmonary artery pressure by "pull back" technique [8].

• Ventricular Hypertrophy

  ECG: may show right ventricular hypertrophy, right atrial hypertrophy and right axis deviation. Angiography: may be required in children with multiple cardiac abnormalities. [patient.info]

  The electrocardiogram shows right ventricular hypertrophy and right atrial dilatation, while posteroanterior and lateral chest radiography highlights a dilated pulmonary trunk and diminished pulmonary vascularization. [symptoma.com]

  This results in right ventricular pressure overload, right ventricular hypertrophy and eventual right ventricular heart failure. The vast majority of cases of pulmonic valve stenosis are congenital. [healio.com]

  Can have a normal heart size or may show evidence of right ventricular hypertrophy. May also show evidence of a dilated pulmonary trunk or a main pulmonary artery. Pulmonary vascularity is often normal in mild cases. [radiopaedia.org]

  […] for blue blood to reach the lungs), right ventricular hypertrophy (thickening of the heart muscle from pumping blood past the narrowing) and an overriding aorta. [advancingyourhealth.org]

• Prominent A-Wave

  The jugular pulse may have a prominent "A" wave. If the pulmonary regurgitation component is severe, the heart may be enlarged, pulsatile and painful. [symptoma.com]

  The pressure wave form in the right atrium shows the characteristic prominent systolic V wave with rapid descent only in the most severe cases. [revespcardiol.org]

  With increasing right ventricular hypertrophy, right ventricular compliance decreases with a resultant increase in end-diastolic pressure and with prominent a waves in the right atrium. [emedicine.medscape.com]

  In case of severe stenosis the following changes can be noted, which include: [46] Features of right ventricular hypertrophy Rightward axis deviation High R wave amplitude in lead V1 Deep S waves in the left precordial leads with Chest X-Ray Vascular [wikidoc.org]

Humanitas Research Humanitas is a world-famous center of excellence for research and treatment of immune system-related disease. [humanitas.net]

Pulmonary Valve Disease Treatment Cardiovascular treatments are not required for most cases of pulmonary valve disease. Pulmonary regurgitation as the result of pulmonary hypertension may require you to take medication. [dignityhealth.org]

Options You may not need immediate treatment if you have mild or moderate symptoms. [heart.uvahealth.com]

Symptoms of Pulmonary Valve Disease Patients with pulmonary valve disease may not notice symptoms, but may need treatment before symptoms develop if the pulmonary valve is severely affected. [houstonmethodist.org]

If treatment is required, a procedure called a balloon valvuloplasty is often the recommended treatment option in children and younger people. [nhs.uk]

Prognosis Pulmonary regurgitation is usually well tolerated in childhood. [patient.info]

Support Groups Expectations (prognosis) Without surgery, most infants who have severe lung complications will die. Surgery can treat the condition and relieve symptoms in many cases. [mostellarmedical.org]

Fortunately, the prognosis for children with this condition has greatly improved over the last several decades (assuming proper diagnosis and treatment is administered). [advancingyourhealth.org]

Thus, emphasis should be placed on the importance of prophylaxis in affording a good prognosis for recovery even in patients with severe heart disease and prevention of recurrence to reduce cardiac morbidity from this disease. [file.scirp.org]

Congenital etiologies cause an abnormal development of distal bulbus cordis secondary to: Rubella embryopathy (most important etiology) Isolated branch pulmonary artery stenosis (stenosis of a sling of the ductus arteriosus) Congenital/genetic syndromes [unboundmedicine.com]

Etiology, pathogenesis and hemodynamics of diseases of both valves have been dealt in simple and comprehensible manner. Special effort has been made to explain the clinical features (Symptoms and signs) of disease. [authorhouse.com]

Symptoms caused by underlying etiology such as flushing, diarrhea, abdominal pain, etc. associated with carcinoid heart disease point to the etiology. [revespcardiol.org]

Specific features depend on the etiology, which affects the level at which the obstruction to right ventricular outflow occurs: valvular pulmonic stenosis most common cause level of obstruction thickened and/or structurally abnormal valve leaflets leaflets [radiopaedia.org]

Etiology can be organic or functional. [textbookofcardiology.org]

Valves made from animal or human tissue (are used for valve replacement), in adults metal valves can be used. [9] [10] Epidemiology [ edit ] The epidemiology of pulmonary valve stenosis can be summed up by the congenital aspect which is the majority of [en.wikipedia.org]

Both pulmonary stenosis (PS) and pulmonary regurgitation are often well tolerated for long periods but the overload of the right ventricle has a progressively detrimental effect on right ventricular function. [ 1 ] Epidemiology Pulmonary valve disease [patient.info]

Explore these free sample topics: -- The first section of this topic is shown below -- Basics Description Deformity of pulmonary valve, most commonly congenital, resulting in obstruction of right ventricular (RV) outflow Epidemiology Incidence Predominant [unboundmedicine.com]

Seckeler, M.D. and Hoke, T.R. (2011) The Worldwide Epidemiology of Acute Rheumatic Fever and Rheumatic Heart Disease. Clinical Epidemiology, 3, 67-84. http://dx.doi.org/10.2147/CLEP.S12977 7. [file.scirp.org]

Linguistic Variant - Portuguese, Brazil) 2015AB LNC-RU-RU (LOINC Linguistic Variant - Russian, Russia) 2015AB LNC-TR-TR (LOINC Linguistic Variant - Turkish, Turkey) 2015AB LNC-ZH-CN (LOINC Linguistic Variant - Chinese, China) 2015AB MCM (Glossary of Clinical Epidemiologic [doctor.am]

The cause in turn is divided into: valvular, external and intrinsic (when it is acquired). [1] Pathophysiology [ edit ] The pathophysiology of pulmonary valve stenosis consists of the valve leaflets becoming too thick (therefore not separate one from [en.wikipedia.org]

These haemodynamic findings are similar to recent studies in bicuspid aortic disease, and suggest the importance of flow patterns in the pathophysiology of vessel dilation in both aortic and pulmonary bicuspid valve disease. [rdm.ox.ac.uk]

[…] male ( 1 ) African Americans (46.5%), Hispanics (33.1%), and Caucasians (20.4%) ( 1 ) Prevalence 10% of all cases of congenital heart disease In association with other lesions, may be as high as 25–30% of congenital heart disease ( 1 ) Etiology and Pathophysiology [unboundmedicine.com]

Abstract Pulmonary hypertension (PH) is a classic pathophysiological consequence of left-sided valvular heart disease (VHD). [imaging.onlinejacc.org]

Prevention Though pulmonary valve disease cannot be prevented, there are a few measures that can be taken to improve overall health and slow the development of heart disease. [humanitas.net]

It can help to prevent an infection of the valve. Not everyone with valve stenosis will need this step. [winchesterhospital.org]

Children’s heart conditions can’t be prevented, but a lot can be done to improve and often completely repair their hearts at any age. [nemours.org]

Prevention Get prompt treatment for a sore throat that lasts longer than 48 hours, especially if accompanied by a fever. Timely administration of antibiotics may prevent the development of rheumatic fever which can cause valvular heart disease. [hopkinsmedicine.org]

Preventative Antibiotics and Heart Valve Disease Patients with heart valve disease who have an abnormal heart or who have had heart surgery risk developing endocarditis. [ihimontanafoundation.org]

1. Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease;a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the management of patients with Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Throacic Surgeons. Circulation. 2006;114:e84-e231.
2. Waller BF, Howard J, Fess S. Pathology of pulmonic valve stenosis and pure regurgitation. Clin Cardiol. 1995;18:45–50.
3. Kitagawa A, Oka N, Kimura S, et al. Clinical utility of the plasma brain natriuretic peptide level in monitoring tetralogy of Fallot patients over the long term after initial intracardiac repair: considerations for pulmonary valve replacement. Pediatr Cardiol. 2015;36(4):752-758.
4. Lei MH, Chen JJ, Ko YL, Cheng JJ, Kuan P, Lien WP. Reappraisal of quantitative evaluation of pulmonary regurgitation and estimation of pulmonary artery pressure by continuous wave Doppler echocardiography. Cardiology. 1995;86:249–256.
5. Silvilairat S, Cabalka AK, Cetta F, Hagler DJ, O’Leary PW. Echocardiographic assessment of isolated pulmonary valve stenosis: which outpatient Doppler gradient has the most clinical validity? J Am Soc Echocardiogr. 2005;18:1137–1142.
6. Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification. Eur J Echocardiogr. 2006;7:79–108.
7. Didier D, Ratib O, Lerch R, et al. Detection and quantification of valvular heart disease with dynamic cardiac MR imaging. Radiographics. 2000;20 (5): 1279-1299.
8. Williams RV, Minich LL, Shaddy RE, et al. Comparison of Doppler echocardiography with angiography for determining the severity of pulmonary regurgitation. Am J Cardiol. 2002;89:1438–1441.