Pulmonary stenosis

Introduction Pulmonary artery stenosis refers to the passage between the right ventricle and the pulmonary artery, due to the constriction of congenital malformation, and the ventricular septum is intact. This is one of the common congenital cardiovascular diseases. Common types of stenosis are stenosis, stenosis of the funnel, and narrowing of the pulmonary artery. They may each exist separately or together. The symptoms and development of the disease are related to the degree of stenosis. Mild stenosis can be asymptomatic. Symptoms of severe stenosis appear early, and purpura and heart failure gradually develop. The curative effect of this disease is exact and the cure rate is high. Most patients with poor efficacy or death are those who are not treated promptly, are critically ill or have other cardiac malformations. Therefore, it should be diagnosed early and treated early.

Cause

During the first 3 months of pregnancy, the fetus can cause pulmonary stenosis for a variety of reasons. Two important reasons worth pointing out are environmental factors: rubella syndrome and family genetic factors.

If the mother suffers from rubella during the first 3 months of pregnancy, the fetus can develop rubella syndrome, which is manifested as cataract, deafness and cardiovascular malformation. The most common cardiovascular malformation is pulmonary stenosis or pulmonary stenosis. . Recent studies have found that there is familial pulmonary stenosis, the incidence rate in the brothers is 2.9%; in other syndromes such as Noonan syndrome, there may be pulmonary stenosis, but the cause of most patients has not been confirmed.

an examination

Related inspection

Doppler echocardiography two-dimensional echocardiography angiography electrocardiogram

1. After exertion, have heart palpitations, shortness of breath, chest pain or syncope.

2. The second intercostal space on the left sternal border and the squeaky spur of the systolic period, with the second sound of the tremor artery flap weakened or disappeared.

3. Electrocardiogram: the right axis of the electric axis, P wave high tip, right ventricular hypertrophy.

4. X-ray examination, the right ventricle is enlarged, the pulmonary artery cone is bulged, and the hilar blood vessel shadow is reduced and slender.

5. Color Doppler echocardiography: The right ventricle is enlarged to determine the anatomical location and extent of the stenosis.

6. Cardiac catheterization: The systolic pressure gradient between the right ventricle and the pulmonary artery exceeds 1.3 Kpa.

Differential diagnosis

Physical examination should pay attention to whether there is rough or jet systolic tremor and murmur between the 3rd and 4th ribs in the pulmonary valve area or the left sternal border. Pay attention to whether the second sound of the pulmonary artery is weakened or disappeared. If there is a cyanosis, the identification is central or peripheral, pay attention to the presence or absence of signs of liver-neck pulsation.

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