Pulmonary valve stenosis echocardiogram
Pulmonary valve stenosis |
Differentiating Pulmonary valve stenosis from other Diseases |
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Diagnosis |
Treatment |
Case Studies |
Pulmonary valve stenosis echocardiogram On the Web |
American Roentgen Ray Society Images of Pulmonary valve stenosis echocardiogram |
Risk calculators and risk factors for Pulmonary valve stenosis echocardiogram |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Echocardiography
2D Echocardiography
- Thickened leaflets with systolic bowing in valvular stenosis.
- Difficult to distinguish between valvular, sub valvular and supra valvular stenosis with 2D echocardiography.
- Post stenotic pulmonary artery dilatation can be visualised sometimes.
Doppler Echocardiography
- Ante grade velocity increased with corresponding maximum and mean pressure gradients.
- Pulmonary valve area can be calculated using the continuity equation.
- Pulmonary Valve Area = (Cross sectional areaRVOT * VTIRVOT)/ VTIPV
- The site of obstruction can be difficult to diagnose by 2D echo. Cautious use of colour flow mapping and PW Doppler can pin point the location of obstruction.
- Pulmonic Stenosis 1
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- Pulmonic Stenosis 2
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- Pulmonic Stenosis 3
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Severity Assessment
Severity | mild | moderate | severe |
---|---|---|---|
Valve area | >1.0 | 1- 0.5 | <0.5 |
Peak gradient (mm Hg) | <10-25 | 25-40 | >40 |
ACC / AHA Guidelines - Recommendations for Evaluation of the Unoperated Patient. (DO NOT EDIT)
Class I |
"1.Two-dimensional echocardiography-Doppler, chest x-ray, and ECG are recommended for the initial evaluation of patients with valvular PS.(Level of Evidence: C) " |
"2.A follow-up physical examination, echocardiography-Doppler, and ECG are recommended at 5-year intervals in the asymptomatic patient with a peak instantaneous valvular gradient by Doppler less than 30 mm Hg.(Level of Evidence: C) " |
"3.A follow-up echocardiography-Doppler is recommended every 2 to 5 years in the asymptomatic patient with a peak instantaneous valvular gradient by Doppler greater than 30 mm Hg.(Level of Evidence: C) " |
Class III |
"1.Cardiac catheterization is unnecessary for diagnosis of valvular PS and should be used only when percutaneous catheter intervention is contemplated.(Level of Evidence: C) " |
2008 ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease (DO NOT EDIT)[1]
Class I |
"1. Transthoracic Doppler echocardiography is recommended for the initial evaluation of pulmonic stenosis in adolescent and young adult patients, and serially every 5 to 10 years for follow-up examinations. (Level C)" |
Sources
- 2008 ACC/AHA Guidelines incorporated into the 2006 guidelines for the management of patients with valvular heart disease [1]
References
- ↑ 1.0 1.1 Bonow RO, Carabello BA, Chatterjee K; et al. (2008). "2008 Focused update incorporated into the 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): endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". Circulation. 118 (15): e523–661. doi:10.1161/CIRCULATIONAHA.108.190748. PMID 18820172. Unknown parameter
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