Pulmonic regurgitation history and symptoms: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(Created page with "__NOTOC__ {{Pulmonic regurgitation}} {{CMG}}{{AE}}{{AKI}}{{AA}} ==Overview== ==History == In mild to moderate cases, pulmonic regurgitation is asymptompatic. In more severe...")
 
No edit summary
Line 6: Line 6:
==Overview==
==Overview==


==History ==
==History and Symptoms==
In mild to moderate cases, pulmonic regurgitation is asymptompatic. In more severe pulmonic regurgitation, patients may develop right ventricular dilatation and systolic dysfunction. Patients with early right ventricular dysfunction are often categorized as [[NYHA class]] 1.<ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref><ref name="pmid7421291">{{cite journal| author=Wessel HU, Cunningham WJ, Paul MH, Bastanier CK, Muster AJ, Idriss FS| title=Exercise performance in tetralogy of Fallot after intracardiac repair. | journal=J Thorac Cardiovasc Surg | year= 1980 | volume= 80 | issue= 4 | pages= 582-93 | pmid=7421291 | doi= | pmc= | url= }} </ref> At this stage, research suggests that diagnostic measures such as [[exercise testing]] may indicate varying levels of exercise intolerance.<ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref><ref name="pmid1622697">{{cite journal| author=Carvalho JS, Shinebourne EA, Busst C, Rigby ML, Redington AN| title=Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation. | journal=Br Heart J | year= 1992 | volume= 67 | issue= 6 | pages= 470-3 | pmid=1622697 | doi= | pmc=PMC1024889 | url= }} </ref> As right ventricular failure progresses, right ventricular dysfunction becomes more symptomatic. Symptoms may include: [[dyspnea on exertion]], [[peripheral edema]], [[ chest pain]] and [[fatigue]]. Patients may also complain of [[palpitations]], [[light-headedness]], as well as frank [[syncope]].  Advanced or later symptoms include the development of [[ascites]], right upper quadrant pain (as a result of hepatic distension), and [[early satiety]].<ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref>
Clinical presentation of pulmonary regurgitation varies on the severity of the regurgitation and the right ventricular function.<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e143-263 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677  }} </ref><ref name="pmid6207619">{{cite journal| author=Shimazaki Y, Blackstone EH, Kirklin JW| title=The natural history of isolated congenital pulmonary valve incompetence: surgical implications. | journal=Thorac Cardiovasc Surg | year= 1984 | volume= 32 | issue= 4 | pages= 257-9 | pmid=6207619 | doi=10.1055/s-2007-1023399 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6207619  }} </ref>
*Isolated pulmonary regurgitation is usually asymptomatic and is an incidental finding on 2D echo even when the regurgitation is severe.
*Patients with chronic PR develop right heart failure and present with the following symptoms:
**Intitial symptom of chronic PR is  functional limitation of physical activity
**[[Ankle edema]] or [[swelling of the feet]] and legs
**[[Dyspnea|Dyspnea on exertion]]
**[[Fatigue]]
**[[Hemoptysis]] or frothy sputum
**[[cough|Nocturnal cough]]
**[[Palpitation]]s or [[extra heart beats]]
*Patients with arrythmias present with palpitations, dizziness, or an episode of syncope<ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref><ref name="pmid7421291">{{cite journal| author=Wessel HU, Cunningham WJ, Paul MH, Bastanier CK, Muster AJ, Idriss FS| title=Exercise performance in tetralogy of Fallot after intracardiac repair. | journal=J Thorac Cardiovasc Surg | year= 1980 | volume= 80 | issue= 4 | pages= 582-93 | pmid=7421291 | doi= | pmc= | url= }} </ref> At this stage, research suggests that diagnostic measures such as [[exercise testing]] may indicate varying levels of exercise intolerance.<ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref><ref name="pmid1622697">{{cite journal| author=Carvalho JS, Shinebourne EA, Busst C, Rigby ML, Redington AN| title=Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation. | journal=Br Heart J | year= 1992 | volume= 67 | issue= 6 | pages= 470-3 | pmid=1622697 | doi= | pmc=PMC1024889 | url= }} </ref> As right ventricular failure progresses, right ventricular dysfunction becomes more symptomatic. Symptoms may include: [[dyspnea on exertion]], [[peripheral edema]], [[ chest pain]] and [[fatigue]]. Patients may also complain of [[palpitations]], [[light-headedness]], as well as frank [[syncope]].  Advanced or later symptoms include the development of [[ascites]], right upper quadrant pain (as a result of hepatic distension), and [[early satiety]].<ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref>


Prior to the age of 40, symptom onset is rare. Patients over 40 may potentially develop symptoms of right heart failure and present the risk of sudden cardiac death. <ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref><ref name="pmid6207619">{{cite journal| author=Shimazaki Y, Blackstone EH, Kirklin JW| title=The natural history of isolated congenital pulmonary valve incompetence: surgical implications. | journal=Thorac Cardiovasc Surg | year= 1984 | volume= 32 | issue= 4 | pages= 257-9 | pmid=6207619 | doi=10.1055/s-2007-1023399 | pmc= | url= }} </ref>
Prior to the age of 40, symptom onset is rare. Patients over 40 may potentially develop symptoms of right heart failure and present the risk of sudden cardiac death. <ref name="pmid15640261">{{cite journal| author=Bouzas B, Kilner PJ, Gatzoulis MA| title=Pulmonary regurgitation: not a benign lesion. | journal=Eur Heart J | year= 2005 | volume= 26 | issue= 5 | pages= 433-9 | pmid=15640261 | doi=10.1093/eurheartj/ehi091 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15640261  }} </ref><ref name="pmid6207619">{{cite journal| author=Shimazaki Y, Blackstone EH, Kirklin JW| title=The natural history of isolated congenital pulmonary valve incompetence: surgical implications. | journal=Thorac Cardiovasc Surg | year= 1984 | volume= 32 | issue= 4 | pages= 257-9 | pmid=6207619 | doi=10.1055/s-2007-1023399 | pmc= | url= }} </ref>
==Symptoms==
Care should be paid to symptoms that might be associated with an underlying etiology of the pulmonic regurgitation.




Revision as of 20:06, 30 December 2016

Pulmonic regurgitation Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differential diagnosis

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X-Ray

Echocardiography

Cardiac MRI

Severity Assessment

Treatment

Medical Therapy

Surgical therapy

Follow up

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]Aysha Anwar, M.B.B.S[3]

Overview

History and Symptoms

Clinical presentation of pulmonary regurgitation varies on the severity of the regurgitation and the right ventricular function.[1][2]

Prior to the age of 40, symptom onset is rare. Patients over 40 may potentially develop symptoms of right heart failure and present the risk of sudden cardiac death. [3][2]


References

  1. ↑ Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e143–263. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.
  2. ↑ 2.0 2.1 Shimazaki Y, Blackstone EH, Kirklin JW (1984). "The natural history of isolated congenital pulmonary valve incompetence: surgical implications". Thorac Cardiovasc Surg. 32 (4): 257–9. doi:10.1055/s-2007-1023399. PMID 6207619.
  3. ↑ 3.0 3.1 3.2 3.3 Bouzas B, Kilner PJ, Gatzoulis MA (2005). "Pulmonary regurgitation: not a benign lesion". Eur Heart J. 26 (5): 433–9. doi:10.1093/eurheartj/ehi091. PMID 15640261.
  4. ↑ Wessel HU, Cunningham WJ, Paul MH, Bastanier CK, Muster AJ, Idriss FS (1980). "Exercise performance in tetralogy of Fallot after intracardiac repair". J Thorac Cardiovasc Surg. 80 (4): 582–93. PMID 7421291.
  5. ↑ Carvalho JS, Shinebourne EA, Busst C, Rigby ML, Redington AN (1992). "Exercise capacity after complete repair of tetralogy of Fallot: deleterious effects of residual pulmonary regurgitation". Br Heart J. 67 (6): 470–3. PMC 1024889. PMID 1622697.

Template:WH

Retrieved from "https://www.wikidoc.org/index.php?title=Pulmonic_regurgitation_history_and_symptoms&oldid=1278515"