肺動脈弁閉鎖不全症
WordNet
- backflow of blood through a defective heart valve
- recall after rote memorization; "he complained that school was just memorization and regurgitation"
PrepTutorEJDIC
- public relations
- 逆流 / (未消化食物の)吐きもどし,反芻(はんすう) / 血液の逆流
- 肺の;肺を冒す
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/16 18:27:15」(JST)
[Wiki en表示]
| 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]
|
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]
Contents
- 1 Signs and symptoms
- 2 Causes
- 3 Pathophysiology
- 4 Diagnosis
- 5 Treatment
- 6 See also
- 7 References
- 8 Further reading
- 9 External links
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
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]
See also
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.
- ^ 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.
Further reading
- Lake, Carol L.; Booker, Peter D. (2005-01-01). Pediatric Cardiac Anesthesia. Lippincott Williams & Wilkins. ISBN 9780781751759.
- Bruce, Charles J.; Connolly, Heidi M. (2009-05-26). "Right-Sided Valve Disease Deserves a Little More Respect". Circulation 119 (20): 2726–2734. doi:10.1161/CIRCULATIONAHA.108.776021. ISSN 0009-7322. PMID 19470901.
- M.D, Steven Lehrer (2011-12-27). Understanding Pediatric Heart Sounds. Steven Lehrer. ISBN 9781468138030.
External links
- "Problem: Pulmonary Valve Regurgitation". www.heart.org. Retrieved 2015-08-29.
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Cardiovascular disease I00–I52, 390–429
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| Ischaemic |
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Coronary disease
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- Coronary artery disease (CAD)
- Coronary artery aneurysm
- Coronary artery dissection
- Coronary thrombosis
- Coronary vasospasm
- Myocardial bridge
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|
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Active ischemia
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- Angina pectoris
- Prinzmetal's angina
- Stable angina
- Acute coronary syndrome
- Myocardial infarction
- Unstable angina
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Sequelae
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- hours
- Hibernating myocardium
- Myocardial stunning
- days
- weeks
- Aneurysm of heart / Ventricular aneurysm
- Dressler syndrome
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|
|
| Layers |
|
Pericardium
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- Pericarditis
- Acute
- Chronic / Constrictive
- Pericardial effusion
- Cardiac tamponade
- Hemopericardium
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|
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Myocardium
|
- Myocarditis
- Cardiomyopathy: Dilated (Alcoholic), Hypertrophic, and Restrictive
- Loeffler endocarditis
- Cardiac amyloidosis
- Endocardial fibroelastosis
- Arrhythmogenic right ventricular dysplasia
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|
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Endocardium /
valves
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Endocarditis
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- infective endocarditis
- Subacute bacterial endocarditis
- non-infective endocarditis
- Libman–Sacks endocarditis
- Nonbacterial thrombotic endocarditis
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|
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Valves
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- mitral
- regurgitation
- prolapse
- stenosis
- aortic
- tricuspid
- pulmonary
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|
|
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Conduction /
arrhythmia |
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Bradycardia
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- Sinus bradycardia
- Sick sinus syndrome
- Heart block: Sinoatrial
- AV
- Intraventricular
- Bundle branch block
- Right
- Left
- Left anterior fascicle
- Left posterior fascicle
- Bifascicular
- Trifascicular
- Adams–Stokes syndrome
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|
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Tachycardia
(paroxysmal and sinus)
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Supraventricular
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- Atrial
- Junctional
- AV nodal reentrant
- Junctional ectopic
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Ventricular
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- Accelerated idioventricular rhythm
- Catecholaminergic polymorphic
- Torsades de pointes
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Premature contraction
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- Atrial
- Junctional
- Ventricular
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Pre-excitation syndrome
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- Lown–Ganong–Levine
- Wolff–Parkinson–White
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Flutter / fibrillation
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- Atrial flutter
- Ventricular flutter
- Atrial fibrillation
- Ventricular fibrillation
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|
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Pacemaker
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- Ectopic pacemaker / Ectopic beat
- Multifocal atrial tachycardia
- Pacemaker syndrome
- Parasystole
- Wandering pacemaker
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Long QT syndrome
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- Andersen–Tawil
- Jervell and Lange-Nielsen
- Romano–Ward
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Cardiac arrest
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- Sudden cardiac death
- Asystole
- Pulseless electrical activity
- Sinoatrial arrest
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Other / ungrouped
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- hexaxial reference system
- Right axis deviation
- Left axis deviation
- QT
- T
- ST
- Osborn wave
- ST elevation
- ST depression
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| Cardiomegaly |
- Ventricular hypertrophy
- Left
- Right / Cor pulmonale
- Atrial enlargement
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| Other |
- Cardiac fibrosis
- Heart failure
- Diastolic heart failure
- Cardiac asthma
- Rheumatic fever
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Congenital heart defects (Q20–Q24, 745–746)
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Cardiac shunt/
heart septal defect |
| Aortopulmonary septal defect |
- R→L: Double outlet right ventricle
- Transposition of the great vessels
- Persistent truncus arteriosus
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| Atrial septal defect |
- L→R: Sinus venosus atrial septal defect
- Lutembacher's syndrome
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| Ventricular septal defect |
- L→R and R→L: Eisenmenger's syndrome
- R→L, with other conditions: Tetralogy of Fallot
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| Atrioventricular septal defect |
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Valvular heart disease/
heart chambers |
| Right |
- pulmonary valves
- tricuspid valves
- stenosis
- atresia
- Ebstein's anomaly
- Hypoplastic right heart syndrome
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| Left |
- aortic valves
- stenosis
- insufficiency
- bicuspid
- mitral valves
- Hypoplastic left heart syndrome
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| Other |
- Dextrocardia
- Levocardia
- Cor triatriatum
- Crisscross heart
- Brugada syndrome
- Coronary artery anomaly
- Anomalous aortic origin of a coronary artery
- Ventricular inversion
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|
UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
English Journal
- Preservation of right ventricular structure and function following transatrial-transpulmonary repair of tetralogy of Fallot.
- Sfyridis PG, Kirvassilis GV, Papagiannis JK, Avramidis DP, Ieromonachos CG, Zavaropoulos PN, Sarris GE.SourceDepartment of Paediatric and Congenital Heart Surgery, Mitera Children's Hospital and Hygeia Hospital, Athens, Greece.
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Feb;43(2):336-42. doi: 10.1093/ejcts/ezs221. Epub 2012 May 24.
- OBJECTIVES: Management strategy of patients with tetralogy of Fallot (TOF)-including timing, as well as surgical technique-remains a controversial topic. We sought to analyse both early and late results of our consistent policy of non-neonatal transatrial/transpulmonary (TA/TP) repair of TOF over al
- PMID 22627661
- Long-term results of the arterial switch operation for ventriculo-arterial discordance.
- Lim HG, Kim WH, Lee JR, Kim YJ.SourceDepartment of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.Eur J Cardiothorac Surg.2013 Feb;43(2):325-34. doi: 10.1093/ejcts/ezs264. Epub 2012 May 9.
- OBJECTIVES: The arterial switch operation (ASO) has become the standard surgical procedure for transposition of the great arteries (TGA) or variants with an excellent early outcome. However, there are concerns regarding neopulmonary stenosis, neoaortic regurgitation (neoAR) associated with neoaortic
- PMID 22573720
- Dynamic annuloplasty for mitral regurgitation.
- Langer F, Borger MA, Czesla M, Shannon FL, Sakwa M, Doll N, Cremer JT, Mohr FW, Schäfers HJ.SourceDepartment of Thoracic and Cardiovascular Surgery, University Hospital Homburg, Germany. Electronic address: frank.langer@uks.eu.
- The Journal of thoracic and cardiovascular surgery.J Thorac Cardiovasc Surg.2013 Feb;145(2):425-9. doi: 10.1016/j.jtcvs.2011.12.062. Epub 2012 Feb 24.
- OBJECTIVE: The MiCardia DYANA annuloplasty system (MiCardia Corp, Irvine, Calif) is a nitinol-based dynamic complete ring that allows modification of the septal-lateral diameter under transesophageal echocardiography guidance in the loaded beating heart after mitral valve repair. Shape alteration is
- PMID 22365061
Japanese Journal
- Monocrotaline-induced pulmonary hypertension with sufficient tricuspid regurgitation in a rat model
- ISHIKURA Fuminobu,AZAKAMI Ryoko,ASANUMA Toshihiko,BEPPU Shintaro
- Journal of medical ultrasonics : official journal of the Japan Society of Ultrasonics in Medicine 39(4), 221-226, 2012-10-15
- NAID 10031122866
- Successful Surgical Repair of Pulmonary Artery Aneurysm and Regurgitation
- SHIRAISHI Manabu,YAMAGUCHI Atsushi,MORITA Hideki,ADACHI Hideo
- Annals of thoracic and cardiovascular surgery 18(5), 491-493, 2012-10-01
- NAID 10031120940
- New Human Leukocyte Antigen Risk Allele in Japanese Patients With Takayasu Arteritis
- TAKAMURA Chisato,OHHIGASHI Hirokazu,EBANA Yusuke,ISOBE Mitsuaki
- Circulation journal : official journal of the Japanese Circulation Society 76(7), 1697-1702, 2012-06-25
- … We next studied the association of HLA-B67 and -B52 with clinical characteristics: age at disease onset, distribution of arteritis, pulmonary involvement, aortic regurgitation, systemic hypertension, steroid resistance and recurrence rate in TA. …
- NAID 10030503559
Related Links
- Pulmonary regurgitation (PR, also called pulmonic regurgitation) is a leaky pulmonary valve. This valve helps control the flow of blood passing from the heart to the lungs. A leaky pulmonary valve allows blood to flow back ...
- Pulmonic (pulmonary) regurgitation (PR) is incompetency of the pulmonic valve causing blood flow from the pulmonary artery into the right ventricle during diastole. The most common cause is pulmonary hypertension. PR is usually ...
- 16B. Using pulmonary regurgitation to measure mean PAP and PA end-diastolic pressure Using pulmonary regurgitation to measure mean PAP and PA end-diastolic pressure Luke Howard
★リンクテーブル★
[★]
[★]
肺動脈弁閉鎖不全、肺動脈弁閉鎖不全症
- 関
- pulmonary insufficiency、pulmonary regurgitation、pulmonary valve incompetence、pulmonary valve regurgitation、pulmonic insufficiency、pulmonic regurgitation
[★]
- 英
- pulmonary insufficiency、pulmonic regurgitation、pulmonic insufficiency、pulmonary valve insufficiency、pulmonary regurgitation
- 関
- 肺動脈弁閉鎖不全症、肺動脈弁逆流、肺動脈弁逆流症
[★]
- 英
- pulmonary regurgitation、pulmonic regurgitation、pulmonary valve regurgitation、pulmonic valve regurgitation
- 関
- 肺動脈弁閉鎖不全、肺動脈弁閉鎖不全症、肺動脈弁逆流症
[★]
肺動脈弁逆流、肺動脈弁逆流症
- 関
- pulmonary regurgitation、pulmonary valve incompetence、pulmonary valve insufficiency、pulmonic regurgitation、pulmonic valve regurgitation
[★]
- 同
- 逆流
[★]
- 関
- lung、pneumo