bubble_chart Overview

Pulmonary stenosis refers to the narrowing of the passage between the right ventricle and the pulmonary artery caused by congenital malformation, with an intact ventricular septum. This is one of the common congenital cardiovascular diseases. Common types of stenosis include valvular stenosis, infundibular stenosis, and pulmonary artery stenosis. These can occur individually or coexist. The symptoms and progression of the disease are related to the degree of stenosis. Patients with grade I stenosis may be asymptomatic, while those with grade III stenosis may experience early symptoms, gradually developing cyanosis and heart failure. Surgical treatment for this condition is highly effective, with a high cure rate. Poor outcomes or fatalities are mostly due to delayed treatment, severe conditions, or accompanying cardiac malformations. Therefore, early diagnosis and treatment are essential.

bubble_chart Clinical Manifestations

1. After exertion, there may be palpitations, shortness of breath, chest pain, or syncope; severe cases can present with cyanosis and right heart failure. Grade I stenosis patients may be asymptomatic.
2. A rough systolic ejection murmur is heard at the second left intercostal space, accompanied by a thrill. The pulmonary component of the second heart sound is weakened or absent.

bubble_chart Diagnosis

1. Palpitation, shortness of breath, chest pain, or syncope after exertion;
2. A rough systolic ejection murmur is heard at the second left intercostal space near the sternum, accompanied by a thrill, and the second heart sound is weakened or absent.
3. Electrocardiogram: Right axis deviation, peaked P waves, and right ventricular hypertrophy.
4. X-ray examination: Right ventricular enlargement, prominence of the pulmonary conus, reduced and thinned hilar vascular shadows.
5. Color Doppler echocardiography: Right ventricular enlargement, determining the anatomical location and severity of the stenosis.
6. Cardiac catheterization: The systolic pressure gradient between the right ventricle and the pulmonary artery exceeds 1.3 kPa.

bubble_chart Treatment Measures

1. The patient has no obvious clinical symptoms, normal electrocardiogram, and normal cardiac shadow on X-ray examination, so surgical treatment is not necessary.
2. If symptoms are obvious, electrocardiogram or X-ray shows right ventricular hypertrophy, and the systolic pressure difference between the right ventricle and pulmonary artery exceeds 5.3 KPA, surgical treatment should be performed.
3. Surgical treatment: Perform pulmonary stirred pulse stenosis correction under extracorporeal circulation.

This disease is a congenital malformation and can generally be diagnosed by B-ultrasound. Simple pulmonary stirred pulse valve stenosis can be treated with balloon catheter dilation. Grade III and pulmonary stirred pulse stenosis require surgical correction of the stenosis.

bubble_chart Cure Criteria

1. Cure: The surgery relieves the stenosis, with X-ray showing significant improvement in pulmonary ischemia, normalization of right heart enlargement, and a marked reduction or disappearance of murmurs, along with notable clinical symptom improvement.
2. Improvement: Postoperative clinical symptoms improve, with X-ray follow-up showing only slight increase in pulmonary blood flow and minimal reduction in right ventricular size.
3. No improvement: Symptoms show no change after medical treatment.