Pulmonic Stenosis

 

Image Library Home >>Valvular Disease>> Pulmonic Stenosis

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Pulmonic stenosis is frequently a congenital lesion due to cusp fusion or myxomatous thickening with valve dysplasia; therefore the valve is not necessarily calcified. This parasternal short axis view with color Doppler across the pulmonic valve shows highly turbulent flow suggestive of stenosis.

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The 2D image obtained before the color Doppler image above shows a dysplastic and non calcified pulmonic valve. Also note the post stenosis dilation of the pulmonary artery, another common finding in this condition.
Pulsed wave Doppler above and below the valve shows a clear step up in velocities from under 1 meter/sec to an aliased flow.
CW Doppler demonstrates that the peak velocity and mean and peak gradients were elevated consistent with moderate pulmonic stenosis. (See this page for criteria).

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It is important to assess RV size and function as RV pressure and volume overload may be seen in the case of severe stenosis. Frequently RV size and function are normal as in this individual as shown in the apical 4 chamber view. However some degree of RV hypertrophy may be present.