What is pulmonary valve regurgitation
Pulmonary valve regurgitation, also known as pulmonic regurgitation, is a leaky pulmonary valve (the valve that controls the flow of blood from the heart to the lungs).
Regurgitation refers to when heart valves leak when the blood flows back through the valve as the leaflets close or when blood leaks through the leaflets when they are closed.
Pulmonary regurgitation is very common and can affect up to 90% of the population. Many infants and children are not diagnosed until later in life.
Causes of pulmonary valve regurgitation
Pulmonary hypertension and congenital heart defects are the primary causes of pulmonary valve regurgitation.
Pulmonary valve regurgitation can be caused by:
- Infective endocarditis
- Complications after tetralogy of Fallot surgery
- Carcinoid syndrome
- Rheumatic fever
Risk factors for pulmonary valve regurgitation
Conditions that increase your risk for developing a pulmonary valve regurgitation include:
- Pulmonary hypertension
- Endocarditis
- Left-side heart disease
Heart procedures that can increase your risk of developing pulmonary regurgitation include:
- Tetralogy of Fallot surgery
- Ross procedure (with prosthetic pulmonary valve replacement)
Symptoms of pulmonary valve regurgitation
The only early sign that indicates pulmonary valve regurgitation is a certain type of heart murmur that can be heard during a physical exam.
As the condition progresses, the heart may enlarge due to the valve problem or pulmonary hypertension and you may feel symptoms such as:
- Chest pain, pressure or tightness in the chest
- Fatigue
- Lightheadedness
- Dizziness or fainting
- Swelling in the legs or feet
- Bluish colors to the nails or lips
Diagnosis of pulmonary valve regurgitation
Your doctor may be able to diagnose pulmonary valve regurgitation in a medical exam if he or she hears a specific heart murmur between the beats.
Other signs that point to pulmonary valve regurgitation include:
- Enlarged liver
- Retention of fluid in ankles
- Distention in the jugular vein (neck)
Diagnostic tests that can diagnose pulmonary valve regurgitation include:
- Echocardiogram — maps the heart using sound waves.
- Electrocardiogram (ECG or EKG) — monitors the heart’s rhythm.
- Chest x-ray — takes pictures of the heart and lungs to look for pulmonary valve issues.
- Cardiac catheterization (cardiac cath) — evaluates the condition of the heart.
Treatment for pulmonary valve regurgitation
The goal of treatment for pulmonary valve regurgitation is to treat the underlying condition causing the valve problem. Pulmonary valve replacement is rare.
Mild to moderate cases of pulmonary regurgitation can be monitored until the disease progresses. As the disease worsens, treatment options include:
Medication
Your doctor may prescribe medications that treat the symptoms caused by your pulmonary valve regurgitation.
Surgical treatments
When medication alone is not sufficient to treat the regurgitation, surgery may be necessary. Surgical treatment for pulmonary valve regurgitation include:
- Pulmonary valve repair or replacement — although rare, some patients need a pulmonary valve repair or replacement in order to restore blood flow and preserve heart muscle.
- Right ventricle to pulmonary artery (RV-PA) conduit replacement — can be used to fix a leaky pulmonary valve with the replacement made from cadaver valved tissue, valved bovine jugular vein, pig or manufactured valves.
- Percutaneous transcatheter pulmonary valve replacement (TPVR) — a newer minimally invasive treatment option for pulmonary valve regurgitation; this procedure uses smaller incisions and offers shorter recovery time.