Difference between revisions of "Pulmonic regurgitation causes"

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(Causes)
(Causes)
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==Causes==
 
==Causes==
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===Life-threatening causes===
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*Life-threatening causes of [[PR]] include [[trauma]] as described below.
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===Common causes===
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*Secondary [[PR]] is more common than primary [[PR]].<ref>{{cite book | last = Fauci | first = Anthony | title = Harrison's principles of internal medicine | publisher = McGraw-Hill Medical | location = New York | year = 2008 | isbn = 978-0071466332 }}</ref>
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*[[PR|pulmonic regirgitation]] (PR) is most common after [[TOF]] repair.<ref name="WarnesWilliams2008">{{cite journal|last1=Warnes|first1=Carole A.|last2=Williams|first2=Roberta G.|last3=Bashore|first3=Thomas M.|last4=Child|first4=John S.|last5=Connolly|first5=Heidi M.|last6=Dearani|first6=Joseph A.|last7=del Nido|first7=Pedro|last8=Fasules|first8=James W.|last9=Graham|first9=Thomas P.|last10=Hijazi|first10=Ziyad M.|last11=Hunt|first11=Sharon A.|last12=King|first12=Mary Etta|last13=Landzberg|first13=Michael J.|last14=Miner|first14=Pamela D.|last15=Radford|first15=Martha J.|last16=Walsh|first16=Edward P.|last17=Webb|first17=Gary D.|title=ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary|journal=Circulation|volume=118|issue=23|year=2008|pages=2395–2451|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.108.190811}}</ref><ref name="WeinbergMcElhinney2014">{{cite journal|last1=Weinberg|first1=Catherine R.|last2=McElhinney|first2=Doff B.|title=Pulmonary Valve Replacement in Tetralogy of Fallot|journal=Circulation|volume=130|issue=9|year=2014|pages=795–798|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.114.005551}}</ref>
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*[[PR]] is also common in [[patients]] with [[pulmonary hypertension]] (PAH).<ref name="SaremiGera2014">{{cite journal|last1=Saremi|first1=Farhood|last2=Gera|first2=Atul|last3=Yen Ho|first3=S.|last4=Hijazi|first4=Ziyad M.|last5=Sánchez-Quintana|first5=Damián|title=CT and MR Imaging of the Pulmonary Valve|journal=RadioGraphics|volume=34|issue=1|year=2014|pages=51–71|issn=0271-5333|doi=10.1148/rg.341135026}}</ref>
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===Less common causes===
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*[[Carcinoid syndrome|Carconoid heart disease]], [[infective endocarditis]], [[tertiary syphilis]], and [[connective tissue disorders]] are uncommon causes of [[PR]].<ref name="SaremiGera2014">{{cite journal|last1=Saremi|first1=Farhood|last2=Gera|first2=Atul|last3=Yen Ho|first3=S.|last4=Hijazi|first4=Ziyad M.|last5=Sánchez-Quintana|first5=Damián|title=CT and MR Imaging of the Pulmonary Valve|journal=RadioGraphics|volume=34|issue=1|year=2014|pages=51–71|issn=0271-5333|doi=10.1148/rg.341135026}}</ref>
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*[[Rheumatic heart disease]] is also an uncommon cause and is more commonly observed in developing countries.
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===Causes by etiology===
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*[[PR]] may be physiologic or pathologic. Pathologic causes may be divided among primary and secondary. Isolated PR is very rare and is most commonly associated with other [[congenital heart diseases]].<ref name="pmid17569817">{{cite journal| author=Chaturvedi RR, Redington AN| title=Pulmonary regurgitation in congenital heart disease. | journal=Heart | year= 2007 | volume= 93 | issue= 7 | pages= 880-9 | pmid=17569817 | doi=10.1136/hrt.2005.075234 | pmc=1994453 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17569817  }} </ref>  The following flow chart demonstrates the causes of [[PR]] based upon the etiology.<br>
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{{familytree | | | | | | | | | | | | | A01 | | | | | |A01='''Causes of [[Pulmonic regurgitation]]''' (PR)}}
 
{{familytree | | | | | | | | | | | | | A01 | | | | | |A01='''Causes of [[Pulmonic regurgitation]]''' (PR)}}
 
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{{familytree | | | | | | B01 | | | | | B02 | | | | B03 |B01='''Physiologic'''<ref name="pmid8304596">{{cite journal |vauthors=Macchi C, Orlandini SZ, Orlandini GE |title=An anatomical study of the healthy human heart by echocardiography with special reference to physiological valvular regurgitation |journal=Ann. Anat. |volume=176 |issue=1 |pages=81–6 |date=January 1994 |pmid=8304596 |doi=10.1016/s0940-9602(11)80421-8 |url=}}</ref><ref name="pmid2637102">{{cite journal |vauthors=Král J, Hradec J, Petrásek J |title=Valvular regurgitations in healthy young people |journal=Cor Vasa |volume=31 |issue=6 |pages=485–94 |date=1989 |pmid=2637102 |doi= |url=}}</ref><ref name="pmid1760180">{{cite journal |vauthors=Maciel BC, Simpson IA, Valdes-Cruz LM, Recusani F, Hoit B, Dalton N, Weintraub R, Sahn DJ |title=Color flow Doppler mapping studies of "physiologic" pulmonary and tricuspid regurgitation: evidence for true regurgitation as opposed to a valve closing volume |journal=J Am Soc Echocardiogr |volume=4 |issue=6 |pages=589–97 |date=1991 |pmid=1760180 |doi=10.1016/s0894-7317(14)80218-6 |url=}}</ref><br>Mostly found in healthy young people on [[Doppler echocardiography|doppler echo]]|B02='''Primary'''<ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref>|B03='''Secondary'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref> }}
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{{familytree | | | | | | B01 | | | | | B02 | | | | B03 |B01='''Physiologic'''<ref name="pmid8304596">{{cite journal |vauthors=Macchi C, Orlandini SZ, Orlandini GE |title=An anatomical study of the healthy human heart by echocardiography with special reference to physiological valvular regurgitation |journal=Ann. Anat. |volume=176 |issue=1 |pages=81–6 |date=January 1994 |pmid=8304596 |doi=10.1016/s0940-9602(11)80421-8 |url=}}</ref><ref name="pmid2637102">{{cite journal |vauthors=Král J, Hradec J, Petrásek J |title=Valvular regurgitations in healthy young people |journal=Cor Vasa |volume=31 |issue=6 |pages=485–94 |date=1989 |pmid=2637102 |doi= |url=}}</ref><ref name="pmid1760180">{{cite journal |vauthors=Maciel BC, Simpson IA, Valdes-Cruz LM, Recusani F, Hoit B, Dalton N, Weintraub R, Sahn DJ |title=Color flow Doppler mapping studies of "physiologic" pulmonary and tricuspid regurgitation: evidence for true regurgitation as opposed to a valve closing volume |journal=J Am Soc Echocardiogr |volume=4 |issue=6 |pages=589–97 |date=1991 |pmid=1760180 |doi=10.1016/s0894-7317(14)80218-6 |url=}}</ref><br>Mostly found in healthy young people on [[Doppler echocardiography|doppler echo]]|B02='''Primary'''<ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref>|B03='''Secondary'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref><ref name="SaremiGera2014">{{cite journal|last1=Saremi|first1=Farhood|last2=Gera|first2=Atul|last3=Yen Ho|first3=S.|last4=Hijazi|first4=Ziyad M.|last5=Sánchez-Quintana|first5=Damián|title=CT and MR Imaging of the Pulmonary Valve|journal=RadioGraphics|volume=34|issue=1|year=2014|pages=51–71|issn=0271-5333|doi=10.1148/rg.341135026}}</ref><ref name="pmid28053559">{{cite journal |vauthors=Tselios K, Gladman DD, Urowitz MB |title=Systemic lupus erythematosus and pulmonary arterial hypertension: links, risks, and management strategies |journal=Open Access Rheumatol |volume=9 |issue= |pages=1–9 |date=2017 |pmid=28053559 |pmc=5191623 |doi=10.2147/OARRR.S123549 |url=}}</ref> }}
 
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{{familytree | | | | | | | | | | | | | |!| | |E01| | | | E02|E01=•[[Pulmonary artery]] dilation<br>•Right [[ventricle|ventricular]] outlet [[aneurysm]]|E02=•[[Pulmonary hypertension]]}}
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{{familytree | | | | | | | | | | | | | |!| | |E01| | | | E02|E01=•[[Pulmonary artery]] dilation<br>•Right [[ventricle|ventricular]] outlet [[aneurysm]]<br>•[[Behçet disease]] <br>•[[Tertiary syphilis]]|E02=•[[Pulmonary hypertension]] (PAH)<br>•[[SLE]] (via [[PAH]]}}
 
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{{familytree | | | | | | | | | |F01| | | | F02 | |F01='''Acquired'''|F02='''[[Congenital]]'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><br>•Quadricuspid or [[Bicuspid valve]]s<br>•[[Valve|Valvular]] [[hypoplasia]]<br>•[[pulmonary valve]][[Prolapse]]<br>•[[Absent pulmonary valve]]<br>•Isolated [[congenital]] PR<br>•[[Ebstein’s anomaly]] ([[acute]] PR)<br>•[[Right ventricular outflow tract obstruction pulmonary supravalvular stenosis|Peripheral pulmonary artery stenosis]]}}
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{{familytree | | | | | | | | | |F01| | | | F02 | |F01='''Acquired'''|F02='''[[Congenital]]'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><br>•Quadricuspid or [[Bicuspid valve]]s<br>•[[Valve|Valvular]] [[hypoplasia]]<br>•[[pulmonary valve]] [[prolapse]]<br>•[[Absent pulmonary valve]]<br>•Isolated [[congenital]] PR<br>•[[Ebstein’s anomaly]] ([[acute]] PR)<br>•[[Right ventricular outflow tract obstruction pulmonary supravalvular stenosis|Peripheral pulmonary artery stenosis]]}}
 
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{{familytree | | C01 | | C02 | | | | | C03 | | C04 | |C01='''[[Trauma]]''' (usually life-threatening)<ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref> <br>•[[chest trauma|Blunt or penetrating chest trauma]]<br>•[[Myocardial rupture]]<br>|C02='''Infectious'''/'''Immune-related'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><br>•[[Infective endocarditis]] (can be life-threatening)<br>•[[Rheumatic heart disease]]<br>|C03='''Tumor'''/'''Genetic causes'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><ref name="pmid15367531">{{cite journal |vauthors=Fox DJ, Khattar RS |title=Carcinoid heart disease: presentation, diagnosis, and management |journal=Heart |volume=90 |issue=10 |pages=1224–8 |date=October 2004 |pmid=15367531 |pmc=1768473 |doi=10.1136/hrt.2004.040329 |url=}}</ref><br>•[[Carcinoid syndrome|Carconoid heart disease]]<br>•[[Myxomatous degeneration]] of the [[pulmonary valve]]<br>|C04='''Iatrogenic'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><ref name="pmid11436049">{{cite journal| author=Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P et al.| title=Long-term results after early primary repair of tetralogy of Fallot. | journal=J Thorac Cardiovasc Surg | year= 2001 | volume= 122 | issue= 1 | pages= 154-61 | pmid=11436049 | doi=10.1067/mtc.2001.115156 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11436049  }}</ref><ref name="pmid26656195">{{cite journal| author=Jonas SN, Kligerman SJ, Burke AP, Frazier AA, White CS| title=Pulmonary Valve Anatomy and Abnormalities: A Pictorial Essay of Radiography, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). | journal=J Thorac Imaging | year= 2016 | volume= 31 | issue= 1 | pages= W4-12 | pmid=26656195 | doi=10.1097/RTI.0000000000000182 | pmc= |url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26656195  }} </ref><ref name="pmid26564602">{{cite journal| author=Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D et al.| title=Percutaneous Pulmonary Valve Implantation: Present Status and Evolving Future. | journal=J Am Coll Cardiol | year= 2015 | volume= 66 | issue= 20 | pages= 2246-55 | pmid=26564602 | doi=10.1016/j.jacc.2015.09.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26564602  }} </ref><br>•Post [[Pulmonary valve stenosis|pulmonary valve  stenosis]] repair<br>• Post [[Tetralogy of Fallot|TOF]] transannular patch repair<br>•Post [[Blalock-Taussig shunt]] [[Tetralogy of Fallot|TOF]] repair<br>•Post balloon or surgical valvulotomy or [[valvuloplasty]] for [[pulmonary stenosis]] (acute PR)<br>•Perforation of valvular [[pulmonary atresia]] ([[acute]] PR)<br>•[[Medication|Medications]] acting via [[serotonin|serotonergic pathways]] such as [[ergot]] derivatives ([[Pergolide]])<ref name="CorvolAnzouan-Kacou2007">{{cite journal|last1=Corvol|first1=Jean-Christophe|last2=Anzouan-Kacou|first2=Jean-Baptiste|last3=Fauveau|first3=Elodie|last4=Bonnet|first4=Anne-Marie|last5=Lebrun-Vignes|first5=Bénédicte|last6=Girault|first6=Camille|last7=Agid|first7=Yves|last8=Lechat|first8=Philippe|last9=Isnard|first9=Richard|last10=Lacomblez|first10=Lucette|title=Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease|journal=Archives of Neurology|volume=64|issue=12|year=2007|pages=1721|issn=0003-9942|doi=10.1001/archneur.64.12.1721}}</ref><ref name="pmid19553085">{{cite journal |vauthors=Smith SA, Waggoner AD, de las Fuentes L, Davila-Roman VG |title=Role of serotoninergic pathways in drug-induced valvular heart disease and diagnostic features by echocardiography |journal=J Am Soc Echocardiogr |volume=22 |issue=8 |pages=883–9 |date=August 2009 |pmid=19553085 |pmc=3808845 |doi=10.1016/j.echo.2009.05.002 |url=}}</ref>}}
 
{{familytree | | C01 | | C02 | | | | | C03 | | C04 | |C01='''[[Trauma]]''' (usually life-threatening)<ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref> <br>•[[chest trauma|Blunt or penetrating chest trauma]]<br>•[[Myocardial rupture]]<br>|C02='''Infectious'''/'''Immune-related'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><br>•[[Infective endocarditis]] (can be life-threatening)<br>•[[Rheumatic heart disease]]<br>|C03='''Tumor'''/'''Genetic causes'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><ref name="pmid15367531">{{cite journal |vauthors=Fox DJ, Khattar RS |title=Carcinoid heart disease: presentation, diagnosis, and management |journal=Heart |volume=90 |issue=10 |pages=1224–8 |date=October 2004 |pmid=15367531 |pmc=1768473 |doi=10.1136/hrt.2004.040329 |url=}}</ref><br>•[[Carcinoid syndrome|Carconoid heart disease]]<br>•[[Myxomatous degeneration]] of the [[pulmonary valve]]<br>|C04='''Iatrogenic'''<ref name="LancellottiTribouilloy2010">{{cite journal|last1=Lancellotti|first1=P.|last2=Tribouilloy|first2=C.|last3=Hagendorff|first3=A.|last4=Moura|first4=L.|last5=Popescu|first5=B. A.|last6=Agricola|first6=E.|last7=Monin|first7=J. L.|last8=Pierard|first8=L. A.|last9=Badano|first9=L.|last10=Zamorano|first10=J. L.|last11=Sicari|first11=R.|last12=Vahanian|first12=A.|last13=Roelandt|first13=J. R. T. C.|title=European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)|journal=European Journal of Echocardiography|volume=11|issue=3|year=2010|pages=223–244|issn=1525-2167|doi=10.1093/ejechocard/jeq030}}</ref><ref name="pmid11436049">{{cite journal| author=Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P et al.| title=Long-term results after early primary repair of tetralogy of Fallot. | journal=J Thorac Cardiovasc Surg | year= 2001 | volume= 122 | issue= 1 | pages= 154-61 | pmid=11436049 | doi=10.1067/mtc.2001.115156 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11436049  }}</ref><ref name="pmid26656195">{{cite journal| author=Jonas SN, Kligerman SJ, Burke AP, Frazier AA, White CS| title=Pulmonary Valve Anatomy and Abnormalities: A Pictorial Essay of Radiography, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). | journal=J Thorac Imaging | year= 2016 | volume= 31 | issue= 1 | pages= W4-12 | pmid=26656195 | doi=10.1097/RTI.0000000000000182 | pmc= |url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26656195  }} </ref><ref name="pmid26564602">{{cite journal| author=Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D et al.| title=Percutaneous Pulmonary Valve Implantation: Present Status and Evolving Future. | journal=J Am Coll Cardiol | year= 2015 | volume= 66 | issue= 20 | pages= 2246-55 | pmid=26564602 | doi=10.1016/j.jacc.2015.09.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26564602  }} </ref><br>•Post [[Pulmonary valve stenosis|pulmonary valve  stenosis]] repair<br>• Post [[Tetralogy of Fallot|TOF]] transannular patch repair<br>•Post [[Blalock-Taussig shunt]] [[Tetralogy of Fallot|TOF]] repair<br>•Post balloon or surgical valvulotomy or [[valvuloplasty]] for [[pulmonary stenosis]] (acute PR)<br>•Perforation of valvular [[pulmonary atresia]] ([[acute]] PR)<br>•[[Medication|Medications]] acting via [[serotonin|serotonergic pathways]] such as [[ergot]] derivatives ([[Pergolide]])<ref name="CorvolAnzouan-Kacou2007">{{cite journal|last1=Corvol|first1=Jean-Christophe|last2=Anzouan-Kacou|first2=Jean-Baptiste|last3=Fauveau|first3=Elodie|last4=Bonnet|first4=Anne-Marie|last5=Lebrun-Vignes|first5=Bénédicte|last6=Girault|first6=Camille|last7=Agid|first7=Yves|last8=Lechat|first8=Philippe|last9=Isnard|first9=Richard|last10=Lacomblez|first10=Lucette|title=Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease|journal=Archives of Neurology|volume=64|issue=12|year=2007|pages=1721|issn=0003-9942|doi=10.1001/archneur.64.12.1721}}</ref><ref name="pmid19553085">{{cite journal |vauthors=Smith SA, Waggoner AD, de las Fuentes L, Davila-Roman VG |title=Role of serotoninergic pathways in drug-induced valvular heart disease and diagnostic features by echocardiography |journal=J Am Soc Echocardiogr |volume=22 |issue=8 |pages=883–9 |date=August 2009 |pmid=19553085 |pmc=3808845 |doi=10.1016/j.echo.2009.05.002 |url=}}</ref>}}
{{familytree/end}}
+
{{familytree/end}}<br>
  
===Causes by Organ System<ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref><ref name="pmid15367531">{{cite journal |vauthors=Fox DJ, Khattar RS |title=Carcinoid heart disease: presentation, diagnosis, and management |journal=Heart |volume=90 |issue=10 |pages=1224–8 |date=October 2004 |pmid=15367531 |pmc=1768473 |doi=10.1136/hrt.2004.040329 |url=}}</ref><ref name="pmid11436049">{{cite journal| author=Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P et al.| title=Long-term results after early primary repair of tetralogy of Fallot. | journal=J Thorac Cardiovasc Surg | year= 2001 | volume= 122 | issue= 1 | pages= 154-61 | pmid=11436049 | doi=10.1067/mtc.2001.115156 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11436049  }}</ref><ref name="pmid26656195">{{cite journal| author=Jonas SN, Kligerman SJ, Burke AP, Frazier AA, White CS| title=Pulmonary Valve Anatomy and Abnormalities: A Pictorial Essay of Radiography, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). | journal=J Thorac Imaging | year= 2016 | volume= 31 | issue= 1 | pages= W4-12 | pmid=26656195 | doi=10.1097/RTI.0000000000000182 | pmc= |url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26656195  }} </ref><ref name="pmid26564602">{{cite journal| author=Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D et al.| title=Percutaneous Pulmonary Valve Implantation: Present Status and Evolving Future. | journal=J Am Coll Cardiol | year= 2015 | volume= 66 | issue= 20 | pages= 2246-55 | pmid=26564602 | doi=10.1016/j.jacc.2015.09.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26564602  }} </ref><ref name="CurtissMiller1983">{{cite journal|last1=Curtiss|first1=E I|last2=Miller|first2=T R|last3=Shapiro|first3=L S|title=Pulmonic regurgitation due to valvular tophi.|journal=Circulation|volume=67|issue=3|year=1983|pages=699–701|issn=0009-7322|doi=10.1161/01.CIR.67.3.699}}</ref>===
+
===Causes by Organ System<ref name="pmid18997168">{{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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease). | journal=Circulation | year= 2008 | volume= 118 | issue= 23 | pages= 2395-451 | pmid=18997168 | doi=10.1161/CIRCULATIONAHA.108.190811 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997168  }} </ref><ref name="pmid15367531">{{cite journal |vauthors=Fox DJ, Khattar RS |title=Carcinoid heart disease: presentation, diagnosis, and management |journal=Heart |volume=90 |issue=10 |pages=1224–8 |date=October 2004 |pmid=15367531 |pmc=1768473 |doi=10.1136/hrt.2004.040329 |url=}}</ref><ref name="pmid11436049">{{cite journal| author=Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P et al.| title=Long-term results after early primary repair of tetralogy of Fallot. | journal=J Thorac Cardiovasc Surg | year= 2001 | volume= 122 | issue= 1 | pages= 154-61 | pmid=11436049 | doi=10.1067/mtc.2001.115156 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11436049  }}</ref><ref name="pmid26656195">{{cite journal| author=Jonas SN, Kligerman SJ, Burke AP, Frazier AA, White CS| title=Pulmonary Valve Anatomy and Abnormalities: A Pictorial Essay of Radiography, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). | journal=J Thorac Imaging | year= 2016 | volume= 31 | issue= 1 | pages= W4-12 | pmid=26656195 | doi=10.1097/RTI.0000000000000182 | pmc= |url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26656195  }} </ref><ref name="pmid26564602">{{cite journal| author=Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D et al.| title=Percutaneous Pulmonary Valve Implantation: Present Status and Evolving Future. | journal=J Am Coll Cardiol | year= 2015 | volume= 66 | issue= 20 | pages= 2246-55 | pmid=26564602 | doi=10.1016/j.jacc.2015.09.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26564602  }} </ref><ref name="CurtissMiller1983">{{cite journal|last1=Curtiss|first1=E I|last2=Miller|first2=T R|last3=Shapiro|first3=L S|title=Pulmonic regurgitation due to valvular tophi.|journal=Circulation|volume=67|issue=3|year=1983|pages=699–701|issn=0009-7322|doi=10.1161/01.CIR.67.3.699}}</ref><ref name="SaremiGera2014">{{cite journal|last1=Saremi|first1=Farhood|last2=Gera|first2=Atul|last3=Yen Ho|first3=S.|last4=Hijazi|first4=Ziyad M.|last5=Sánchez-Quintana|first5=Damián|title=CT and MR Imaging of the Pulmonary Valve|journal=RadioGraphics|volume=34|issue=1|year=2014|pages=51–71|issn=0271-5333|doi=10.1148/rg.341135026}}</ref>===
 +
<br>
  
 
{|style="width:80%; height:100px" border="1"
 
{|style="width:80%; height:100px" border="1"
 
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
 
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Congenital heart disease]], [[dilated cardiomyopathy]], [[Eisenmenger syndrome]], [[endocarditis]], [[infective endocarditis]], [[myocardial rupture]], [[patent ductus arteriosus]], [[rheumatic heart disease]], [[cardiac tumors|right ventricular tumors]]
+
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Congenital heart disease]], [[dilated cardiomyopathy]], [[Eisenmenger syndrome]], [[endocarditis]], [[infective endocarditis]], [[myocardial rupture]], [[patent ductus arteriosus]], [[rheumatic heart disease]], [[cardiac tumors|right ventricular tumors]], [[myxomatous degeneration]] of the [[pulmonary valve]]
 
|-
 
|-
 
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
 
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
Line 79: Line 92:
 
|-bgcolor="LightSteelBlue"
 
|-bgcolor="LightSteelBlue"
 
| '''Infectious Disease'''
 
| '''Infectious Disease'''
|bgcolor="Beige"| [[Infective endocarditis]], [[myocarditis]], [[rheumatic fever]]
+
|bgcolor="Beige"| [[Infective endocarditis]], [[myocarditis]], [[rheumatic fever]], [[tertiary syphilis]]
 
|-
 
|-
 
|-bgcolor="LightSteelBlue"
 
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
 
|-bgcolor="LightSteelBlue"
 
| '''Rheumatology/Immunology/Allergy'''
 
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Rheumatic fever]], [[sarcoidosis]]
+
|bgcolor="Beige"| [[Rheumatic fever]], [[sarcoidosis]], [[Behçet disease]]
 
|-
 
|-
 
|-bgcolor="LightSteelBlue"
 
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
 
|-bgcolor="LightSteelBlue"
 
| '''Miscellaneous'''
 
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
+
|bgcolor="Beige"| [[SLE]]
 
|-
 
|-
 
|}
 
|}
 
+
<br>
===Causes in Alphabetical Order===
+
===Causes in alphabetical order===
 
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Revision as of 12:35, 2 August 2020

Home logo1.png

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2] Aravind Kuchkuntla, M.B.B.S[3], Aysha Aslam, M.B.B.S[4]

Overview

A small percentage of pulmonic regurgitation is normal and occasionally a murmur can be heard in thin subjects. The most common causes of pulmonary regurgitation are following repair of tetralogy of Fallot and pulmonary stenosis. In addition, to the physiologic pulmonic regurgitation, the primary causes include an intrinsic pathology in the pulmonic valve. Secondary causes include extrinsic causes. The causes of pulmonic regurgitation can also be reckoned on the basis of the organ systems involved.

Causes

Life-threatening causes

  • Life-threatening causes of PR include trauma as described below.

Common causes

Less common causes

Causes by etiology

  • PR may be physiologic or pathologic. Pathologic causes may be divided among primary and secondary. Isolated PR is very rare and is most commonly associated with other congenital heart diseases.[5] The following flow chart demonstrates the causes of PR based upon the etiology.


 
 
 
 
 
 
 
 
 
 
 
 
Causes of Pulmonic regurgitation (PR)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Physiologic[6][7][8]
Mostly found in healthy young people on doppler echo
 
 
 
 
Primary[9]
 
 
 
Secondary[10][9][4][11]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pulmonary artery dilation
•Right ventricular outlet aneurysm
Behçet disease
Tertiary syphilis
 
 
 
Pulmonary hypertension (PAH)
SLE (via PAH
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acquired
 
 
 
Congenital[10]
•Quadricuspid or Bicuspid valves
Valvular hypoplasia
pulmonary valve prolapse
Absent pulmonary valve
•Isolated congenital PR
Ebstein’s anomaly (acute PR)
Peripheral pulmonary artery stenosis
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Trauma (usually life-threatening)[9]
Blunt or penetrating chest trauma
Myocardial rupture
 
Infectious/Immune-related[10]
Infective endocarditis (can be life-threatening)
Rheumatic heart disease
 
 
 
 
Tumor/Genetic causes[10][12]
Carconoid heart disease
Myxomatous degeneration of the pulmonary valve
 
Iatrogenic[10][13][14][15]
•Post pulmonary valve stenosis repair
• Post TOF transannular patch repair
•Post Blalock-Taussig shunt TOF repair
•Post balloon or surgical valvulotomy or valvuloplasty for pulmonary stenosis (acute PR)
•Perforation of valvular pulmonary atresia (acute PR)
Medications acting via serotonergic pathways such as ergot derivatives (Pergolide)[16][17]
 


Causes by Organ System[9][12][13][14][15][18][4]


Cardiovascular Congenital heart disease, dilated cardiomyopathy, Eisenmenger syndrome, endocarditis, infective endocarditis, myocardial rupture, patent ductus arteriosus, rheumatic heart disease, right ventricular tumors, myxomatous degeneration of the pulmonary valve
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Cabergoline, ergotamine, fenfluramine, fluoxetine, methysergide, paroxetine, pergolide, phentermine, sertraline
Ear Nose Throat No underlying causes
Endocrine Carcinoid syndrome
Environmental Pneumoconiosis
Gastroenterologic No underlying causes
Genetic Mucopolysaccharidoses, patent ductus arteriosus, polycystic kidney disease, X-linked dilated cardiomyopathy
Hematologic No underlying causes
Iatrogenic Balloon valvuloplasty of the pulmonary valve, cardiac catheterization, cardiopulmonary resuscitation, heart surgery, pacemaker syndrome, percutaneous coronary intervention, prosthetic valve dysfunction, Tetralogy of Fallot repair
Infectious Disease Infective endocarditis, myocarditis, rheumatic fever, tertiary syphilis
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic Gouty valvular tophi
Obstetric/Gynecologic No underlying causes
Oncologic Carcinoid syndrome
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Cor pulmonale, idiopathic pulmonary fibrosis, Langerhans cell histiocytosis, pneumoconiosis, pulmonary hypertension, sarcoidosis
Renal/Electrolyte End stage renal disease, polycystic kidney disease
Rheumatology/Immunology/Allergy Rheumatic fever, sarcoidosis, Behçet disease
Sexual No underlying causes
Trauma Blunt or penetrating chest trauma
Urologic No underlying causes
Miscellaneous SLE


Causes in alphabetical order

References

  1. Fauci, Anthony (2008). Harrison's principles of internal medicine. New York: McGraw-Hill Medical. ISBN 978-0071466332.
  2. Warnes, Carole A.; Williams, Roberta G.; Bashore, Thomas M.; Child, John S.; Connolly, Heidi M.; Dearani, Joseph A.; del Nido, Pedro; Fasules, James W.; Graham, Thomas P.; Hijazi, Ziyad M.; Hunt, Sharon A.; King, Mary Etta; Landzberg, Michael J.; Miner, Pamela D.; Radford, Martha J.; Walsh, Edward P.; Webb, Gary D. (2008). "ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: Executive Summary". Circulation. 118 (23): 2395–2451. doi:10.1161/CIRCULATIONAHA.108.190811. ISSN 0009-7322.
  3. Weinberg, Catherine R.; McElhinney, Doff B. (2014). "Pulmonary Valve Replacement in Tetralogy of Fallot". Circulation. 130 (9): 795–798. doi:10.1161/CIRCULATIONAHA.114.005551. ISSN 0009-7322.
  4. 4.0 4.1 4.2 4.3 Saremi, Farhood; Gera, Atul; Yen Ho, S.; Hijazi, Ziyad M.; Sánchez-Quintana, Damián (2014). "CT and MR Imaging of the Pulmonary Valve". RadioGraphics. 34 (1): 51–71. doi:10.1148/rg.341135026. ISSN 0271-5333.
  5. Chaturvedi RR, Redington AN (2007). "Pulmonary regurgitation in congenital heart disease". Heart. 93 (7): 880–9. doi:10.1136/hrt.2005.075234. PMC 1994453. PMID 17569817.
  6. Macchi C, Orlandini SZ, Orlandini GE (January 1994). "An anatomical study of the healthy human heart by echocardiography with special reference to physiological valvular regurgitation". Ann. Anat. 176 (1): 81–6. doi:10.1016/s0940-9602(11)80421-8. PMID 8304596.
  7. Král J, Hradec J, Petrásek J (1989). "Valvular regurgitations in healthy young people". Cor Vasa. 31 (6): 485–94. PMID 2637102.
  8. Maciel BC, Simpson IA, Valdes-Cruz LM, Recusani F, Hoit B, Dalton N, Weintraub R, Sahn DJ (1991). "Color flow Doppler mapping studies of "physiologic" pulmonary and tricuspid regurgitation: evidence for true regurgitation as opposed to a valve closing volume". J Am Soc Echocardiogr. 4 (6): 589–97. doi:10.1016/s0894-7317(14)80218-6. PMID 1760180.
  9. 9.0 9.1 9.2 9.3 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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease)". Circulation. 118 (23): 2395–451. doi:10.1161/CIRCULATIONAHA.108.190811. PMID 18997168.
  10. 10.0 10.1 10.2 10.3 10.4 Lancellotti, P.; Tribouilloy, C.; Hagendorff, A.; Moura, L.; Popescu, B. A.; Agricola, E.; Monin, J. L.; Pierard, L. A.; Badano, L.; Zamorano, J. L.; Sicari, R.; Vahanian, A.; Roelandt, J. R. T. C. (2010). "European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease)". European Journal of Echocardiography. 11 (3): 223–244. doi:10.1093/ejechocard/jeq030. ISSN 1525-2167.
  11. Tselios K, Gladman DD, Urowitz MB (2017). "Systemic lupus erythematosus and pulmonary arterial hypertension: links, risks, and management strategies". Open Access Rheumatol. 9: 1–9. doi:10.2147/OARRR.S123549. PMC 5191623. PMID 28053559.
  12. 12.0 12.1 Fox DJ, Khattar RS (October 2004). "Carcinoid heart disease: presentation, diagnosis, and management". Heart. 90 (10): 1224–8. doi:10.1136/hrt.2004.040329. PMC 1768473. PMID 15367531.
  13. 13.0 13.1 Bacha EA, Scheule AM, Zurakowski D, Erickson LC, Hung J, Lang P; et al. (2001). "Long-term results after early primary repair of tetralogy of Fallot". J Thorac Cardiovasc Surg. 122 (1): 154–61. doi:10.1067/mtc.2001.115156. PMID 11436049.
  14. 14.0 14.1 Jonas SN, Kligerman SJ, Burke AP, Frazier AA, White CS (2016). "Pulmonary Valve Anatomy and Abnormalities: A Pictorial Essay of Radiography, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI)". J Thorac Imaging. 31 (1): W4–12. doi:10.1097/RTI.0000000000000182. PMID 26656195.
  15. 15.0 15.1 Ansari MM, Cardoso R, Garcia D, Sandhu S, Horlick E, Brinster D; et al. (2015). "Percutaneous Pulmonary Valve Implantation: Present Status and Evolving Future". J Am Coll Cardiol. 66 (20): 2246–55. doi:10.1016/j.jacc.2015.09.055. PMID 26564602.
  16. Corvol, Jean-Christophe; Anzouan-Kacou, Jean-Baptiste; Fauveau, Elodie; Bonnet, Anne-Marie; Lebrun-Vignes, Bénédicte; Girault, Camille; Agid, Yves; Lechat, Philippe; Isnard, Richard; Lacomblez, Lucette (2007). "Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease". Archives of Neurology. 64 (12): 1721. doi:10.1001/archneur.64.12.1721. ISSN 0003-9942.
  17. Smith SA, Waggoner AD, de las Fuentes L, Davila-Roman VG (August 2009). "Role of serotoninergic pathways in drug-induced valvular heart disease and diagnostic features by echocardiography". J Am Soc Echocardiogr. 22 (8): 883–9. doi:10.1016/j.echo.2009.05.002. PMC 3808845. PMID 19553085.
  18. Curtiss, E I; Miller, T R; Shapiro, L S (1983). "Pulmonic regurgitation due to valvular tophi". Circulation. 67 (3): 699–701. doi:10.1161/01.CIR.67.3.699. ISSN 0009-7322.
  19. Bhattacharyya S, Schapira AH, Mikhailidis DP, Davar J (2009). "Drug-induced fibrotic valvular heart disease". Lancet. 374 (9689): 577–85. doi:10.1016/S0140-6736(09)60252-X. PMID 19683643.
  20. Sharma S, Kirpalani AL, Kulkarni A (2010). "Severe pulmonary hypertension in a young patient with end-stage renal disease on chronic hemodialysis". Ann Pediatr Cardiol. 3 (2): 184–6. doi:10.4103/0974-2069.74055. PMC 3017928. PMID 21234203.
  21. Hendrikx M, Van Dorpe J, Flameng W, Daenen W (1996). "Aortic and mitral valve disease induced by ergotamine therapy for migraine: a case report and review of the literature". J Heart Valve Dis. 5 (2): 235–7. PMID 8665020.
  22. Wilke A, Hesse H, Hufnagel G, Maisch B (1997). "Mitral, aortic and tricuspid valvular heart disease associated with ergotamine therapy for migraine". Eur Heart J. 18 (4): 701. PMID 9129909.
  23. Nadrous HF, Pellikka PA, Krowka MJ, Swanson KL, Chaowalit N, Decker PA; et al. (2005). "Pulmonary hypertension in patients with idiopathic pulmonary fibrosis". Chest. 128 (4): 2393–9. doi:10.1378/chest.128.4.2393. PMID 16236900.
  24. Chaowalit N, Pellikka PA, Decker PA, Aubry MC, Krowka MJ, Ryu JH; et al. (2004). "Echocardiographic and clinical characteristics of pulmonary hypertension complicating pulmonary Langerhans cell histiocytosis". Mayo Clin Proc. 79 (10): 1269–75. doi:10.4065/79.10.1269. PMID 15473409.
  25. Bana DS, MacNeal PS, LeCompte PM, Shah Y, Graham JR (1974). "Cardiac murmurs and endocardial fibrosis associated with methysergide therapy". Am Heart J. 88 (5): 640–55. PMID 4420941.
  26. Nelson J, Shields MD, Mulholland HC (1990). "Cardiovascular studies in the mucopolysaccharidoses". J Med Genet. 27 (2): 94–100. PMC 1016928. PMID 2108248.
  27. Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE (2002). "Valvular heart disease in patients taking pergolide". Mayo Clin Proc. 77 (12): 1280–6. doi:10.4065/77.12.1280. PMID 12479512.
  28. Adeva M, El-Youssef M, Rossetti S, Kamath PS, Kubly V, Consugar MB; et al. (2006). "Clinical and molecular characterization defines a broadened spectrum of autosomal recessive polycystic kidney disease (ARPKD)". Medicine (Baltimore). 85 (1): 1–21. doi:10.1097/01.md.0000200165.90373.9a. PMID 16523049.
  29. Arkles JS, Opotowsky AR, Ojeda J, Rogers F, Liu T, Prassana V; et al. (2011). "Shape of the right ventricular Doppler envelope predicts hemodynamics and right heart function in pulmonary hypertension". Am J Respir Crit Care Med. 183 (2): 268–76. doi:10.1164/rccm.201004-0601OC. PMID 20709819.
  30. Geva T, Sandweiss BM, Gauvreau K, Lock JE, Powell AJ (2004). "Factors associated with impaired clinical status in long-term survivors of tetralogy of Fallot repair evaluated by magnetic resonance imaging". J Am Coll Cardiol. 43 (6): 1068–74. doi:10.1016/j.jacc.2003.10.045. PMID 15028368.