What Is Pulmonary Stenosis?
Pulmonary stenosis is the narrowing of the pulmonary valve, which controls the flow of blood from the heart’s right ventricle into the pulmonary artery. The pulmonary artery carries blood to the lungs. Stenosis occurs when the valve’s flaps (cusps or leaflets) are thickened or fused together. The narrowed opening of the valve blocks and slows the blood flow into the pulmonary artery.
Pulmonary stenosis usually develops before birth and accounts for almost 10 percent of all congenital heart disease. People with pulmonary valve stenosis need lifelong monitoring by a cardiologist or adult congenital heart disease specialist. Learn more about the Adult Congenital Heart Center at Penn.
Pulmonary Stenosis Symptoms
Mild pulmonary stenosis is rarely symptomatic. As the narrowing becomes more severe, symptoms may include:
- Chest pain: You may feel discomfort in your lungs and chest.
- Shortness of breath: Breathing normally may feel difficult.
- Fainting: You may lose consciousness or feel dizzy.
- Fatigue: You may tire easily with physical exertion.
Although rare, some adults may develop pulmonary stenosis later in life. Risk factors for non-congenital pulmonary stenosis include:
- Carcinoid syndrome, caused by carcinoid tumors in the digestive system
- Rheumatic fever, a rare complication of strep throat
- Radiation to the chest
Diagnosing Pulmonary Stenosis
While it is usually diagnosed in childhood, pulmonary stenosis may go undetected until adulthood or develop later in life. If your pulmonary valve is narrowed, your doctor may hear a heart murmur during a routine examination. Diagnosis of pulmonary stenosis requires additional testing using echocardiography and cardiovascular imaging techniques including:
- Transthoracic echocardiogram (TTE)
- Cardiac magnetic resonance imaging (MRI)
- Cardiac catheterization
At the time of diagnosis, your doctor determines whether your pulmonary stenosis is mild, moderate or severe. The classification is based on the difference between the blood pressure in your right ventricle versus the blood pressure in your pulmonary artery. A severe narrowing causes a bigger difference in blood pressure.
Pulmonary Stenosis Treatment at Penn Medicine
Our cardiology team provides regular monitoring of mild and moderate pulmonary stenosis. If your valve was replaced in childhood, our imaging experts and adult congenital heart disease specialists evaluate your prosthetic valve for signs of dysfunction.
If your pulmonary stenosis is severe, your cardiologist may recommend valve replacement or repair. Treatment for pulmonary valves at Penn includes:
In addition to traditional treatment for pulmonary valve stenosis, Penn researchers are at the forefront of innovations in valve treatment. Through clinical trials, patients have access to new therapies for pulmonary valve replacement and repair not available elsewhere.