What Causes Pulmonary Stenosis?
In children, pulmonary stenosis happens when a baby's heart doesn't develop the
way it should during pregnancy. Doctors don't know why this happens, but it isn't
caused by anything a mother did or didn't do during her pregnancy, so could not have
been prevented.
Who Gets Pulmonary Stenosis?
Most cases of pulmonary stenosis are congenital, meaning a baby is born with it.
How Is Pulmonary Stenosis Diagnosed?
Doctors can often identify pulmonary stenosis before birth. This lets babies with
severe problems be treated right away.
A fetal echocardiogram (also called a fetal echo) is a type of
test that can help diagnose heart defects. A fetal echo uses sound waves to create
a moving picture of the heart. This helps doctors see how the baby's heart looks and
works while still in the mother's womb.
If the problem wasn't found before birth, infants and older kids who have a suspected
heart problem get an echocardiogram. Less commonly, a heart
catheterization may be done if a diagnosis isn't clear. In a catheterization,
a doctor inserts a catheter (a thin plastic, flexible tube) into an artery and vein
that lead to the heart.
How Is Pulmonary Stenosis Treated?
In some cases, pulmonary stenosis doesn't need to be treated. Medicines sometimes
can treat symptoms. In severe cases, though, the pulmonary valve will need to be fixed
or replaced.
Many types of procedures can repair or replace the pulmonary valve. Most severe
cases of pulmonic stenosis can be treated with a balloon valvuloplasty
during heart catheterization. With this procedure, a doctor threads an unopened balloon
through the pulmonary valve and inflates it to open the valve.
Valve replacement involves using an artificial valve or a valve
from a donor.
To decide what treatment to use, doctors consider:
- the location of the narrowing and the amount of narrowing
- the child's age and size
- how well the other valves in the heart are working
- whether the child has had previous heart surgery
- whether the child has other medical conditions
Looking Ahead
A challenge for some kids with pulmonary stenosis is that it can come back again
after treatment. This can happen for different reasons, including scar tissue that
forms after a procedure or a valve replacement that doesn't grow as kids get bigger.
So some kids might need several procedures to keep the valve healthy.
Because pulmonary stenosis can be a lifelong condition, kids who have the defect
will need to see a cardiologist (a doctor who specializes in treating
heart problems) regularly to make sure the narrowing isn't getting worse.
Many children won't need specific medical treatment, and those who do usually can
enjoy most regular activities after their recovery. Kids and teens with moderate or
severe pulmonary stenosis should talk with their cardiologist before playing competitive
sports or being very physically active.
Date reviewed: October 2017