Right ventricular outflow tract obstruction natural history: Difference between revisions

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==Overview==
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
 
OR
 
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].


==Overview==
OR


==Natural History==
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
==Natural History, Complications, and Prognosis==


Among patients with moderate to severe pulmonic stenosis (PS), the gradient often progressively increasesIn patients with mild PS the gradient often remains stable.  
===Natural History===
Patients with [[congenital]] pulmonary stenosis manifest clinical features few hours after birth, in childhood or in adulthood. Manifestation of symptoms, symptom severity and the outcomes are dependent on the severity of [[stenosis]].<ref name="pmid8425320">{{cite journal| author=Hayes CJ, Gersony WM, Driscoll DJ, Keane JF, Kidd L, O'Fallon WM et al.| title=Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis. | journal=Circulation | year= 1993 | volume= 87 | issue= 2 Suppl | pages= I28-37 | pmid=8425320 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8425320 }}</ref> Patients with mild pulmonic stenosis have a benign course and do not progress and patients with moderate and severe stenosis have [[dyspnea]] with exertion and [[syncope]].<ref name="pmid1163423">{{cite journal| author=Mody MR| title=The natural history of uncomplicated valvular pulmonic stenosis. | journal=Am Heart J | year= 1975 | volume= 90 | issue= 3 | pages= 317-21 | pmid=1163423 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1163423  }}</ref>


==Complications==
===Complications===
If left untreated, patients with moderate to severe stenosis progress to develop [[tricuspid regurgitation]] and [[Right ventricular failure|right ventricular dysfunction]] leading to [[right ventricular failure]] and [[arrhythmias]].<ref name="pmid8425327">{{cite journal| author=Wolfe RR, Driscoll DJ, Gersony WM, Hayes CJ, Keane JF, Kidd L et al.| title=Arrhythmias in patients with valvar aortic stenosis, valvar pulmonary stenosis, and ventricular septal defect. Results of 24-hour ECG monitoring. | journal=Circulation | year= 1993 | volume= 87 | issue= 2 Suppl | pages= I89-101 | pmid=8425327 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8425327  }}</ref>


==Prognosis==
===Prognosis===
The prognosis among patients with PS who have reached adulthood without right ventricular failure or symptoms is reported to be good with minimal risk of [[endocarditis]], [[right ventricular]] failure or death.
Patients with moderate to severe pulmonic valve stenosis are managed well with [[surgery]] or [[balloon valvuloplasty]] and have very good prognosis. <ref name="pmid18820172">{{cite journal| author=Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD et al.| title=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. | journal=Circulation | year= 2008 | volume= 118 | issue= 15 | pages= e523-661 | pmid=18820172 | doi=10.1161/CIRCULATIONAHA.108.190748 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18820172  }} </ref>


==References==
==References==
{{reflist|2}}
{{Reflist|2}}


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Latest revision as of 15:59, 27 February 2020

Right ventricular outflow tract obstruction Microchapters

Home

Patient Information

Overview

Anatomy of Pulmonary Valve

Classification

Pulmonary valve stenosis
Pulmonary subvalvular stenosis
Pulmonary supravalvular stenosis
Pulmonary atresia

Pathophysiology

Causes

Differentiating Right ventricular outflow tract obstruction from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Electrocardiogram

Chest X Ray

Echocardiography

Cardiac Catheterization

Pulmonary Angiography

Treatment

Indications For Surgery

Surgery

Pre-Operative A/P

Post-Operative A/P

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Special Scenarios

Pulmonary artery conduits/Prosthetic Valves

Double-Chambered Right Ventricle

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Case #1

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].

OR

Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].

OR

Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.

Natural History, Complications, and Prognosis

Natural History

Patients with congenital pulmonary stenosis manifest clinical features few hours after birth, in childhood or in adulthood. Manifestation of symptoms, symptom severity and the outcomes are dependent on the severity of stenosis.[1] Patients with mild pulmonic stenosis have a benign course and do not progress and patients with moderate and severe stenosis have dyspnea with exertion and syncope.[2]

Complications

If left untreated, patients with moderate to severe stenosis progress to develop tricuspid regurgitation and right ventricular dysfunction leading to right ventricular failure and arrhythmias.[3]

Prognosis

Patients with moderate to severe pulmonic valve stenosis are managed well with surgery or balloon valvuloplasty and have very good prognosis. [4]

References

  1. Hayes CJ, Gersony WM, Driscoll DJ, Keane JF, Kidd L, O'Fallon WM; et al. (1993). "Second natural history study of congenital heart defects. Results of treatment of patients with pulmonary valvar stenosis". Circulation. 87 (2 Suppl): I28–37. PMID 8425320.
  2. Mody MR (1975). "The natural history of uncomplicated valvular pulmonic stenosis". Am Heart J. 90 (3): 317–21. PMID 1163423.
  3. Wolfe RR, Driscoll DJ, Gersony WM, Hayes CJ, Keane JF, Kidd L; et al. (1993). "Arrhythmias in patients with valvar aortic stenosis, valvar pulmonary stenosis, and ventricular septal defect. Results of 24-hour ECG monitoring". Circulation. 87 (2 Suppl): I89–101. PMID 8425327.
  4. Bonow RO, Carabello BA, Chatterjee K, de Leon AC, Faxon DP, Freed MD; 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.

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