pulmonary stenosis

肺動脈弁狭窄症 PS

WordNet

1. abnormal narrowing of a bodily canal or passageway (同)stricture

PrepTutorEJDIC

1. 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）』「2016/04/06 12:37:22」(JST)

wiki en

[Wiki en表示]

Pulmonary valve stenosis is a type of pulmonic stenosis.

Pulmonic stenosis, also known as pulmonary stenosis, is a dynamic or fixed obstruction of flow from the right ventricle of the heart to the pulmonary artery. It is usually first diagnosed in childhood.

Pulmonic stenosis is usually due to isolated valvular obstruction (pulmonary valve stenosis), but it may be due to subvalvular or supravalvular obstruction, such as infundibular stenosis. It may occur in association with other congenital heart defects as part of more complicated syndromes (for example, tetralogy of Fallot).

Pathophysiology

When pulmonary stenosis (PS) is present, resistance to blood flow causes right ventricular hypertrophy. If right ventricular failure develops, right atrial pressure will increase, and this may result in a persistent opening of the foramen ovale, shunting of unoxygenated blood from the right atrium into the left atrium, and systemic cyanosis. If Pulmonary Stenosis is not severe, congestive heart failure occurs, and systemic venous engorgement will be noted. An associated defect such as a patent ductus arteriosus partially compensates for the obstruction by shunting blood from the left ventricle to the aorta then back to the pulmonary artery (as a result of the higher pressure in the left ventricle) and back into the lungs.

Treatment

The treatment of choice is percutaneous balloon valvuloplasty and is done when a resting peak gradient is seen to be >60mm Hg or a mean >40mm Hg is observed.

References

• Ren (Jul. 15, 2009). Pulmonic Stenosis. eMedicine Specialties > Cardiology > Valvular Heart Disease.
• Hockenberry, M. J., & Wilson, D. (2009). Wong's essentials of pediatric nursing. (8 ed., Vol. 1, p. 872). St. Louis, Missouri: Mosby.

External links

• Pulmonary stenosis information for parents.

UpToDate Contents

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• 1. 肺動脈弁狭窄症の臨床症状および診断 clinical manifestations and diagnosis of pulmonic stenosis
• 2. 肺動脈弁狭窄症の自然史および治療 natural history and treatment of pulmonic stenosis
• 3. 肺動脈弁と肺動脈の心エコー評価 echocardiographic evaluation of the pulmonic valve and pulmonary artery
• 4. L型大血管転位 l transposition of the great arteries
• 5. 経皮的肺動脈弁移植 percutaneous pulmonic valve implantation

English Journal

• From the 1990s to CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) Trial Results and Beyond: Does Stenting Have a Role in Ischemic Nephropathy?

• Böhlke M1, Barcellos FC2.
• American journal of kidney diseases : the official journal of the National Kidney Foundation.Am J Kidney Dis.2015 Apr;65(4):611-622. doi: 10.1053/j.ajkd.2014.11.026. Epub 2015 Jan 31.
• The prevalence of atherosclerotic renal artery stenosis is high, ∼7% in individuals older than 65 years and ∼50% in patients with diffuse arterial disease, and it is increasingly frequent in an aging population. About 10% to 15% of atherosclerotic renal artery stenosis cases lead to the developm
• PMID 25649878

• The significance of aortic overriding and pulmonary stenosis in tetralogy of Fallot.

• Yurekli I1, Kestelli M1, Cakir H1, İscan S1.
• Cardiology in the young.Cardiol Young.2015 Apr;25(4):626. doi: 10.1017/S1047951114002662. Epub 2015 Feb 9.
• PMID 25662362

• Three-dimensional patient-specific cardiac model for surgical planning in Nikaidoh procedure.

• Valverde I1, Gomez G2, Gonzalez A3, Suarez-Mejias C2, Adsuar A3, Coserria JF1, Uribe S4, Gomez-Cia T2, Hosseinpour AR3.
• Cardiology in the young.Cardiol Young.2015 Apr;25(4):698-704. doi: 10.1017/S1047951114000742. Epub 2014 May 9.
• PURPOSE: To explore the use of three-dimensional patient-specific cardiovascular models using rapid prototyping techniques (fused deposition modelling) to improve surgical planning in patients with complex congenital heart disease.DESCRIPTION: Rapid prototyping techniques are used to print accurate
• PMID 24809416

Japanese Journal

• 手術の工夫 術後に特異な形態の右肺動脈狭窄・大動脈弁上狭窄をきたした肺動脈弁欠損を伴うFallot四徴症

• 胸部外科 = The Japanese journal of thoracic surgery 68(5), 343-347, 2015-05
• NAID 40020459122

• Infectious Episodes Lead to the Oxidative Stress Response after Lung Transplantation

• American Journal of Case Reports 16, 255-258, 2015-04-30
• NAID 120005615578

• 第80回東京女子医科大学学会総会シンポジウム「東京女子医大 小児医療の最前線!-"なおらない"から"なおる"へ-」Part 1 (2)こどもの心臓病のカテーテル治療

• 東京女子医科大学雑誌 85(2), 44-49, 2015-04-25
• NAID 110009900091

Related Links

• Pulmonary valve stenosis: MedlinePlus Medical Encyclopedia

Pulmonary valve stenosis is a heart valve disorder that involves the pulmonary valve. This is the valve separating the right ventricle (one of the chambers in the heart) and the pulmonary artery. The pulmonary artery carries ...

• Pulmonary valve stenosis - Mayo Clinic

Pulmonary valve stenosis — Comprehensive overview covers symptoms, causes, treatment of this heart condition. ... Pulmonary valve stenosis is a condition in which a deformity on or near your pulmonary valve, the valve that ...

Related Pictures

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★リンクテーブル★

リンク元	「肺動脈弁狭窄症」「PS」「肺動脈狭窄症」「pulmonary stenoses」「pulmonary artery stenosis」
拡張検索	「subvalvular pulmonary stenosis」「infundibular pulmonary stenosis」
関連記事	「pulmonary」

「肺動脈弁狭窄症」

　　[★]

英

pulmonic stenosis, pulmonary stenosis, PS, pulmonary valve stenosis

同

肺動脈狭窄症、肺動脈狭窄

関

右室流出路

• crescendo-decrecscendo murmur at pulmonic area
• right ventricular hypertrophy
• right atrial enlargement would not be present

概念

• 肺動脈弁・弁下・弁上の狭窄

疫学

• 肺動脈弁の狭窄が90%以上を占める(PHD.387)
• 先天性心疾患の10%で肺動脈弁狭窄症が見られる(PHD.387)

病因

参考1

• ファロー四徴症
• 先天性風疹症候群
• カルチノイド症候群の続発症
• ヌーナン症候群

病態

• 右室圧↑　→　右室肥大

重症度

• a peak systolic transvalvular pressure gradient

>50 mmHg : mild

50< < 80 mmHg : moderate

> 80 mmHg : severe

症状

• mild, moderate: 無症状。検診で見つかる
• severe: 運動時の息切れ(dyspnea with exertion), exercise intolerance, ついには右心不全

身体所見

• 頚静脈圧波：a波の亢進
• RV heaveを胸骨上で触れる
• II音減弱
• 収縮期駆出性雑音。ダイヤモンド型。2LSB。

• PS(肺動脈弁狭窄症)の駆出性雑音は吸気で減弱するのが特徴。(PHD.388)
• This occurs bacause with inspiration, the augmented right-sided filling elevates the leaflets into the pulmonary artery prior to RV contraction, preemping the rapid tensing in early systole that is thought to produce the sound.(PHD.388)

• II音分裂音の拡大(A2---P2)

• P弁両側での圧較差の上昇が緩やかだから？

参考

• 1. [charged] Clinical manifestations and diagnosis of pulmonic stenosis - uptodate [1]

国試

• 105A044、102D021

「PS」

　　[★]

• 肺動脈弁狭窄症 pulmonary stenosis
• 肺動脈狭窄 pulmonic stenosis
• phosphatidylserine
• 活動指標 活動指数 performance status
• プロテインS protein S

「肺動脈狭窄症」

　　[★]

英

pulmonary stenosis PS、pulmonary artery stenosis

関

肺動脈弁狭窄、肺動脈狭窄、肺動脈弁狭窄症。先天性肺動脈弁狭窄症

「pulmonary stenoses」

　　[★]

肺動脈狭窄

関

pulmonary artery stenosis、pulmonary stenosis、pulmonary valve stenosis

「pulmonary artery stenosis」

　　[★] 肺動脈狭窄、肺動脈狭窄症

関

pulmonary stenoses、pulmonary stenosis

「subvalvular pulmonary stenosis」

　　[★] 肺動脈漏斗部狭窄症。肺動脈弁下部狭窄症

「infundibular pulmonary stenosis」

　　[★] 肺動脈漏斗部狭窄症

「pulmonary」

　　[★]

• adj.

• 肺の、肺性の

関

lung、pneumo