Pulmonary valve regurgitation (pulmonary valve insufficiency)
Pulmonary valve regurgitation, also known as valve insufficiency, occurs when the heart’s pulmonary valve does not close properly, allowing some blood to leak back into the heart chamber before it flows into the lungs to be oxygenated. This impairs the heart's ability to pump the necessary amount of blood to the rest of the body. Like stenosis, regurgitation is a condition that can affect the heart's mitral, aortic, pulmonary or tricuspid valve.
- Pulmonary hypertension, the most common cause
- A congenital heart defect called tetralogy of Fallot
- Rarer causes include:
- Infective endocarditis, complications after surgery to repair tetralogy of Fallot
- Carcinoid syndrome
- Rheumatic fever and complications after catheterization (rare in the U.S.)
There are usually no early symptoms. Either the valve’s defect itself or the pulmonary hypertension that may been responsible for the problem eventually may cause the lower right (ventricular) chamber of the heart to become enlarged. On occasion, this may lead to heart failure, the symptoms of which can be chest pain or discomfort, fatigue, lightheadedness or fainting.
A medical exam with a stethoscope can reveal a certain type of heart murmur when the heart is between heartbeats. Diagnostic tests that may be applied:
- Echocardiogram — the main diagnostic tool for valve problems
- Exercise test
- Chest X-rays
- Computed tomography (CT) scan
- Exploratory cardiac catheterization — it sometimes is possible to repair a valve during this diagnostic procedure
Treatment for pulmonary valve regurgitation depends on the severity of the condition, often is controlled by treating the underlying cause of the valve problem (i.e., pulmonary hypertension) and usually does not require surgery. Very often, medication is used to treat valvular disease. If your condition is asymptomatic, your doctor may recommend evaluation to manage the disease. However, surgical procedures can be required. Heart valve surgery has become an established and effective treatment for heart valve disease, though it is rarely necessary to replace the pulmonary valve.