Pulmonic regurgitation
| Pulmonic regurgitation | |
| ICD-10 | I37.1, Q22.2 |
|---|---|
| ICD-9 | 424.3, 746.09 |
| DiseasesDB | 11014 |
| eMedicine | med/1964 |
| MeSH | D011665 |
| Cardiology Network |
 Discuss Pulmonic regurgitation further in the WikiDoc Cardiology Network |
| Adult Congenital |
|---|
| Biomarkers |
| Cardiac Rehabilitation |
| Congestive Heart Failure |
| CT Angiography |
| Echocardiography |
| Electrophysiology |
| Cardiology General |
| Genetics |
| Health Economics |
| Hypertension |
| Interventional Cardiology |
| MRI |
| Nuclear Cardiology |
| Peripheral Arterial Disease |
| Prevention |
| Public Policy |
| Pulmonary Embolism |
| Stable Angina |
| Valvular Heart Disease |
| Vascular Medicine |
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Synonyms and related terms: Pulmonary Insufficiency, Pulmonary Incompetence, Pulmonary Valve Regurgitation, Pulmonary Regurgitation, Pulmonary Valve Incompetence.
Pulmonary valve insufficiency (or incompetence, or regurgitation) is a condition where the pulmonary valve is not strong enough to prevent backflow into the right ventricle. Nearly all individuals have physiologic (trace-to-mild) pulmonic regurgitation, and the incidence increases with advancing age.
Pathophysiology
Differential diagnosis of underlying causes
Diagnosis
Symptoms | Physical Examination | Electrocardiogram | Chest X-Ray | Echocardiography : M-mode echocardiography, 2-D Echocardiography, Doppler echocardiography | Pulmonary angiography
Pulmonic regurgitation treatment
If the patient develops right-sided heart failure that is refractory to medical management, pulmonic valve repair or replacement (preferably with a bio prosthetic valve) may be necessary.
Patients with pulmonic regurgitation who become pregnant usually tolerate pulmonic regurgitation well. Exceptions to this rule include, those patients who have undergone surgical repairs for tetralogy of Fallot.
Antibiotic Prophylaxis
The American Heart Association Recommendations on Prevention of Bacterial Endocarditis indicate that antibiotic prophylaxis is not necessary for pulmonic regurgitation in those patients with otherwise structurally normal pulmonic valves, particularly if there is no diastolic murmur. It should be noted, though, that those patients with the following conditions may warrant antibiotic prophylaxis:
- Complex cyanotic heart disease
- Prosthetic heart valves
- Patients with congenital heart disease and pulmonic regurgitation
- Acquired pulmonic valve regurgitation as the result of rheumatic heart disease
- Patients with complex cyanotic heart disease
- In patients who have previously sustained bacterial endocarditis
Prognosis
Patient survival depends upon the underlying etiology of the pulmonic regurgitation. Among patients with pulmonary hypertension, the severity and duration of the pulmonary hypertension will be determinants of the ultimate prognosis. Patients with congenital absence of the pulmonic valve have severe regurgitation and this may limit their life expectancy if the valve is not replaced. Mild to moderate pulmonic regurgitation is not associated with shortened survival.