Pulmonary valve stenosis echocardiogram

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Echocardiography

2D echocardiography

• Thickened leaflets with systolic bowing in valvular stenosis.
• Difficult to distinguish between valvular, sub valvular and supra valvular stenosis with 2D echocardiography.
• Post stenotic pulmonary artery dilatation can be visualised sometimes.

Doppler echocardiography

• Ante grade velocity increased with corresponding maximum and mean pressure gradients.
• Pulmonary valve area can be calculated using the continuity equation.

Pulmonary Valve Area = (Cross sectional area_RVOT * VTI_RVOT)/ VTI_PV

• The site of obstruction can be difficult to diagnose by 2D echo. Cautious use of colour flow mapping and PW Doppler can pin point the location of obstruction.

• Pulmonic Stenosis 1

<googlevideo>6761754875447006755&hl=en</googlevideo>

• Pulmonic Stenosis 2

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• Pulmonic Stenosis 3

<googlevideo>-5141870933248575471&hl=en</googlevideo>

Severity Assessment

Severity of pulmonic stenosis

Severity	mild	moderate	severe
Valve area	>1.0	1- 0.5	<0.5
Peak gradient (mm Hg)	<10-25	25-40	>40