pulmonary stenosis

stenosis /ste·no·sis/ (stĕ-no´sis) pl. steno´ses   [Gr.] stricture; an abnormal narrowing or contraction of a duct or canal.

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aortic stenosis  (AS) a narrowing of the aortic orifice of the heart or of the aorta near the valve.

hypertrophic pyloric stenosis  narrowing of the pyloric canal due to muscular hypertrophy and mucosal edema, usually in infants.

hypertrophic subaortic stenosis , idiopathic hypertrophic subaortic stenosis (IHSS) a form of hypertrophic cardiomyopathy in which the left ventricle is hypertrophied and the cavity is small; it is marked by obstruction to left ventricular outflow.

infantile hypertrophic gastric stenosis  congenital hypertrophy and hyperplasia of the musculature of the pyloric sphincter, leading to partial obstruction of the gastric outlet.

mitral stenosis  a narrowing of the left atrioventricular orifice.

pulmonary stenosis  (PS) narrowing of the opening between the pulmonary artery and the right ventricle, usually at the level of the valve leaflets.

pyloric stenosis  obstruction of the pyloric orifice of the stomach; it may be congenital or acquired.

renal artery stenosis  narrowing of one or both renal arteries, so that renal function is impaired, resulting in renal hypertension and, if stenosis is bilateral, chronic renal failure.

subaortic stenosis  aortic stenosis due to an obstructive lesion in the left ventricle below the aortic valve, causing a pressure gradient across the obstruction within the ventricle.

tricuspid stenosis  (TS) narrowing or stricture of the tricuspid orifice of the heart.

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pulmonary stenosis

n.

Narrowing of the opening into the pulmonary artery from the right ventricle.

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pulmonary stenosis,

an abnormal cardiac condition generally characterized by concentric hypertrophy of the right ventricle with relatively little increase in diastolic volume. When the ventricular septum is intact, this condition may be caused by valvular stenosis, infundibular stenosis, or both; it produces a pressure difference during systole between the right ventricular cavity and the pulmonary artery. Pulmonary stenosis is most often congenital but also may be produced after birth by any of a number of types of lesions. Severe pulmonary stenosis may result in heart failure and death, but mild to moderate forms of this disorder are relatively well tolerated. Also called pulmonic stenosis. See also congenital cardiac anomaly, valvular heart disease, valvular stenosis.

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pulmonary stenosis

Pulmonary valve stenosis Cardiology A narrowed pulmonary annulus, which constitutes ±11% of congenital heart disease–CHD in adults; 90% of PS is valvular, the rest is subvalvular or supravalvular Clinical If severe, DOE, fatigability, retrosternal pain, syncope with exertion Heart sounds With moderate/severe disease, an RV impulse may be palpable at the left sternal border, and there may be a thrill at the 2^nd IC space; the 1^st HS is normal; the 2^nd HS is widely split; a harsh crescendo-decrescendo murmur that ↑ with inspiration is heard along the left sternal border; an ejection click may precede the murmur, if the leaflets are pliable; with ↑ severity, the systolic murmur peaks later, the ejection click is earlier and superimposes on 1^st HS Clinical Sx reflect severity of stenosis, RV function, tricuspid valve competence; if severe, DOE, fatigability, retrosternal pain, syncope with exertion EKG Rt axis deviation, RV hypertrophy Imaging CXR–normal cardiac silhouette–if enlarged, indicates RV failure, tricuspid regurgitation; post-stenotic dilation of main pulmonary artery and ↓ pulmonary vascular markings; Doppler flow allows assessment of severity of obstruction; catheterization and angiography are unnecessary Management If asymptomatic, prophylactic antibiotics to prevent infective endocarditis; if severe, percutaneous balloon valvuloplasty; valve replacement for dysplastic valves. See Supravalvular pulmonary stenosis. Cf Pulmonary regurgitation, Aortic stenosis.