TY - CHAP M1 - Book, Section TI - Pulmonary Valve Stenosis A1 - Bashore, Thomas M. A1 - Granger, Christopher B. A1 - Jackson, Kevin P. A1 - Patel, Manesh R. A2 - Papadakis, Maxine A. A2 - McPhee, Stephen J. A2 - Rabow, Michael W. A2 - McQuaid, Kenneth R. PY - 2022 T2 - Current Medical Diagnosis & Treatment 2022 AB - ESSENTIALS OF DIAGNOSISAsymptomatic unless lesion is at least moderately severe.Severe cases may present with right-sided heart failure.High-pitched systolic ejection murmur maximal in the second left interspace with radiation to the left shoulder.P2 delayed and soft or absent.Pulmonary ejection click often present and decreases with inspiration—the only right heart sound that decreases with inspiration; all other right heart sounds increase.Echocardiography/Doppler is diagnostic.Patients with peak pulmonic valve gradient greater than 64 mm Hg or a mean of 35 mm Hg by echocardiography/Doppler should undergo intervention regardless of symptoms. Otherwise, operate for symptoms or evidence for right ventricular (RV) dysfunction.A dysplastic pulmonary valve usually requires surgical treatment, while a domed pulmonary valve stenosis usually can be treated with balloon valvuloplasty.RV outflow tract obstruction due to conduit stenosis, homograft stenosis and some prior bioprosthetic valve dysfunction may be treated with a percutaneous pulmonary valve replacement. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1184694992 ER -