WordNet

a lack of competence; "pointed out the insufficiencies in my report"; "juvenile offenses often reflect an inadequacy in the parents" (同)inadequacy
(pathology) inability of a bodily part or organ to function normally
lack of an adequate quantity or number; "the inadequacy of unemployment benefits" (同)inadequacy, deficiency

PrepTutorEJDIC

不十分な[点],不足;不適当,不向き
肺の;肺を冒す

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/03 06:17:39」(JST)

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Pulmonary insufficiency (or incompetence, or regurgitation) is a condition in which the pulmonary valve is incompetent^[1] and allows backflow from the pulmonary artery to the right ventricle of the heart during diastole.^[2] While a small amount of backflow may occur ordinarily, it is usually only shown on an echocardiogram and is harmless. More pronounced regurgitation that is noticed through a routine physical examination is a medical sign of disease and warrants further investigation.^{[medical citation needed]} If it is secondary to pulmonary hypertension it is referred to as a Graham Steell murmur.^[3]

Signs and symptoms

Because pulmonic regurgitation is the result of other factors in the body, any noticeable symptoms are ultimately caused by an underlying medical condition rather than the regurgitation itself.^[4] However, more severe regurgitation may contribute to right ventricular enlargement by dilation, and in later stages, right heart failure.^[5] A diastolic decrescendo murmur can sometimes be identified,( heard best) over the left lower sternal border.^{[medical citation needed]}

Causes

Rheumatic heart disease,

Among the causes of pulmonary insufficiency are:

Pulmonary hypertension^[6]
Infective endocarditis^[6]
Rheumatic heart disease^[6]
Connective tissue disease^[5]
Carcinoid syndrome^[5]
Congestive abnormalities^[7]
Tetralogy of Fallot,^[8]
Prosthetic heart valve^[9]

Pathophysiology

The pathophysiology is due to diastolic pressure variations between the pulmonary artery and right ventricle, differences are often very small, but increase regurgitation. An elevation in pulmonary insufficiency due to elevated intrathoracic pressure is relevant in ventilated patients (having acute restrictive right ventricular physiology). The reasons for changes in stiffness of the right ventricle's walls are not well understood, but such stiffness is thought to increase with hypertrophy of the ventricle.^[10]

Diagnosis

In the diagnosis of pulmonary insufficiency both echocardiograms and EKG is used to ascertain if the individual has this condition, as well as, the use of a chest x-ray to expose enlargement of the right atrium or ventricle.^[11]

Treatment

In treating pulmonary insufficiency, it should be determined if pulmonary hypertension is causing the problem to therefore begin the most appropriate therapy as soon as possible (primary pulmonary hypertension or secondary pulmonary hypertension due to thromboembolism).^[12] Furthermore, pulmonary insufficiency is generally treated by addressing the underlying condition,^[4] in certain cases, the pulmonary valve may be surgically replaced.^[13]

References

^ "Pulmonary Insufficiency". FreeDictionary. Farlex. 2014. Retrieved 2015.
^ White, Charles S.; Haramati, Linda B.; Chen, Joseph Jen-Sho; Levsky, Jeffrey M. (2014-03-01). Cardiac Imaging. OUP USA. p. 402. ISBN 9780199829477.
^ Auscultation Skills: Breath & Heart Sounds. Lippincott Williams & Wilkins. 2009-10-01. p. 83. ISBN 9781605474540.
^ ^a ^b McGlothlin, edited by Michael H. Crawford, Komandoor Srivathson, Dana P. (2006). Current consult. New York, NY: Lange Medical Books/McGraw-Hill. p. 269. ISBN 978-0-07144-010-3. |access-date= requires |url= (help)
^ ^a ^b ^c "Pulmonic Regurgitation Clinical Presentation". Medscale.com. eMedicine. Retrieved 29 August 2015.
^ ^a ^b ^c Booker, editors, Carol L. Lake, Peter D. (2005). Pediatric cardiac anesthesia (4th ed.). Philadelphia: Lippincott Williams & Wilkins. p. 430. ISBN 0-7817-5175-6. Retrieved 2015.
^ "pulmonary Valve disease". Patient.info. EMIS Group. Retrieved 29 August 2015.
^ Alpert, Joseph (2012). Cardiology and the Primary care Physician (3rd ed.). Current Medicine. p. 306. ISBN 978-1-4615-6603-8. Retrieved 29 August 2015.
^ O'Connor, Nicholas J. Talley, Simon (2014). Clinical examination : a systematic guide to physical diagnosis (Seventh ed.). Sydney [etc.]: Elsevier, Churchill Livingstone. p. 108. ISBN 978-0-72954-147-3. Retrieved 29 August 2015.
^ Chaturvedi, Rajiv R; Redington, Andrew N (2007-07-01). "Pulmonary regurgitation in congenital heart disease". Heart 93 (7): 880–889. doi:10.1136/hrt.2005.075234. ISSN 1355-6037. PMC 1994453. PMID 17569817.
^ "Pulmonary Valve Disease. About Pulmonary valve disease | Patient". Patient. Retrieved 2015-08-29.
^ "Pulmonic Regurgitation Treatment & Management: Medical Care, Surgical Care, Consultations".
^ "Heart valve surgery: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-08-30.

External links

"Problem: Pulmonary Valve Regurgitation". www.heart.org. Retrieved 2015-08-29.

UpToDate Contents

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1. 肺動脈弁閉鎖不全症 pulmonic regurgitation
2. 成人における心雑音の聴診 auscultation of cardiac murmurs in adults
3. ファロー四徴症のマネージメントおよび転帰 management and outcome of tetralogy of fallot
4. 成人における確定診断を得られていない低血圧やショックの評価および初期アプローチ evaluation of and initial approach to the adult patient with undifferentiated hypotension and shock
5. 肺動脈弁と肺動脈の心エコー評価 echocardiographic evaluation of the pulmonic valve and pulmonary artery

English Journal

Asthma in hispanics. An 8-year update.

Rosser FJ1, Forno E, Cooper PJ, Celedón JC.
American journal of respiratory and critical care medicine.Am J Respir Crit Care Med.2014 Jun 1;189(11):1316-27. doi: 10.1164/rccm.201401-0186PP.
This review provides an update on asthma in Hispanics, a diverse group tracing their ancestry to countries previously under Spanish rule. A marked variability in the prevalence and morbidity from asthma remains among Hispanic subgroups in the United States and Hispanic America. In the United States,
PMID 24881937

Doubly committed and juxtaarterial ventricular septal defect: outcomes of the aortic and pulmonary valves.

Devlin PJ1, Russell HM2, Mongé MC2, Patel A3, Costello JM3, Spicer DE4, Anderson RH5, Backer CL6.
The Annals of thoracic surgery.Ann Thorac Surg.2014 Jun;97(6):2134-41. doi: 10.1016/j.athoracsur.2014.01.059. Epub 2014 Apr 1.
BACKGROUND: The morphology of ventricular septal defects (VSDs) that are doubly committed and juxtaarterial places the patient at risk for aortic valvar prolapse and aortic valvar insufficiency (AI). Surgical repair of this type of defect often involves placing sutures through the base of one or mor
PMID 24698506

Rescue "valve in valve" implantation after late onset corevalve cusp rupture leading to acute massive aortic insufficiency.

Pagnotta P1, Ferrante G, Presbitero P.
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.Catheter Cardiovasc Interv.2014 Jun 1;83(7):E283-6. doi: 10.1002/ccd.23155. Epub 2013 Nov 30.
Transcatheter aortic valve implantation (TAVI) has emerged as a feasible and effective alternative to aortic valve replacement in patients at high surgical risk, and is associated with a lower risk of death at 1 year follow-up when compared with standard therapy. In a recent large study, enrolling 6
PMID 21542120

Japanese Journal

症例報告肺結核に対するリファンピシン投与を機に下垂体茎断裂症候群が判明した1例

広島医学 69(5), 455-459, 2016-05
NAID 40020872126

両心補助で救命し得た重症多臓器不全を来たした劇症型心筋炎の1例

日本心臓血管外科学会雑誌 45(3), 126-130, 2016
NAID 130005157545

大動脈弁狭窄兼閉鎖不全症および上行大動脈瘤を合併した偽性大動脈縮窄症に対し大動脈基部から縮窄部末梢まで人工血管置換術を施行した1 例

日本血管外科学会雑誌 25(0), 110-113, 2016
NAID 130005143878

Related Pictures

★リンクテーブル★

リンク元	「肺動脈弁閉鎖不全症」「pulmonary valve insufficiency」「肺動脈弁閉鎖不全」「PI」「pulmonary valve incompetence」
拡張検索	「cardiopulmonary insufficiency」
関連記事	「insufficiency」「pulmonary」

「肺動脈弁閉鎖不全症」

Pulmonary valve insufficiency
Classification and external resources
Specialty	Cardiology
ICD-10	I37, Q22
ICD-9-CM	424.3, 746.09
DiseasesDB	11014
eMedicine	med/1964
MeSH	D011665
	[edit on Wikidata]