WordNet

control consisting of a mechanical device for controlling the flow of a fluid
device in a brass wind instrument for varying the length of the air column to alter the pitch of a tone
one of the paired hinged shells of certain molluscs and of brachiopods
the entire one-piece shell of a snail and certain other molluscs
a structure in a hollow organ (like the heart) with a flap to insure one-way flow of fluid through it
abnormal narrowing of a bodily canal or passageway (同)stricture
(of brass instruments) having valves

PrepTutorEJDIC

(液体・ガスなどの流れを調節する)『バルブ』,弁 / (血液の流れを調節する)弁,弁膜 / (管楽器の)バルブ / (2枚貝の)から,貝がら / 《英》真空管
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）』「2015/12/02 02:08:32」(JST)

wiki en

Pulmonary valve stenosis (PVS) is a heart valve disorder in which outflow of blood from the right ventricle of the heart is obstructed at the level of the pulmonic valve. This results in the reduction of flow of blood to the lungs.^[1]^[2] Valvular pulmonic stenosis accounts for 80% of right ventricular outflow tract obstruction. While the most common cause of pulmonary valve stenosis is congenital heart disease, it may also be due to a malignant carcinoid tumor. Both stenosis of the pulmonary artery and pulmonary valve stenosis are causes of pulmonic stenosis.^{[medical citation needed]}

Symptoms and Signs

Among some of the symptoms consistent with pulmonary valve stenosis are the following:^[3]

Heart murmur
Cyanosis
Dyspnea
Dizziness
Upper thorax pain
Developmental disorders

Cause

In regards to the cause of pulmonary valve stenosis a very high percentage are congenital, the right ventricular flow is hindered (or obstructed by this). The cause in turn is divided into: valvular, external and intrinsic (when it is acquired).^[4]

Pathophysiology

The pathophysiology of pulmonary valve stenosis consists of the valve leaflets becoming too thick (therefore not separate one from another), which can cause high pulmonary pressure, and pulmonary hypertension. This however, does not mean the cause is always congenital.^[5]

The left ventricle can be changed physically, these changes are a direct result of right ventricular hypertrophy. Once the obstruction is subdued, it (the left ventricle) can return to normal.^[6]

Diagnosis

Play media

Pulmonary valve stenosis-Echocardiogram

The diagnosis of pulmonary valve stenosis can be achieved via echocardiogram, as well as a variety of other means among them are: ultrasound, in which images of the heart chambers in utero where the tricuspid valve has thickening (or due to Fallot's tetralogy, Noonan's syndrome, and other congenital defects) and in infancy auscultation of the heart can reveal identification of a murmur.^[7]

Some other conditions to contemplate (in diagnosis of pulmonic valvular stenosis) are the following:^[3]

Infundibular stenosis
Supravalvular pulmonary stenosis
Dysplastic pulmonic valve stenosis

Treatment

In terms of treatment for pulmonary valve stenosis, valve replacement or surgical repair (depending upon whether the stenosis is in the valve or vessel) may be indicated. If the valve stenosis is of congenital origin, balloon valvuloplasty is another option, depending on the case. Valves made from animal or human tissue (are used for valve replacement), in adults metal valves can be used.^[8]^[9]

Epidemiology

The epidemiology of pulmonary valve stenosis can be summed up by the congenital aspect which is the majority of cases, in broad terms PVS is rare in the general population.^[7]

References

^ "Pulmonary valve stenosis: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-11-18.
^ Choices, NHS. "Congenital heart disease - Types - NHS Choices". www.nhs.uk. Retrieved 2015-11-18.
^ ^a ^b "Pulmonic Valvular Stenosis Clinical Presentation: History, Physical, Causes". emedicine.medscape.com. Retrieved 2015-11-18.
^ Wang, Andrew; Bashore, Thomas M. (2010-01-14). Valvular Heart Disease. Springer Science & Business Media. p. 266. ISBN 9781597454117.
^ Levine, Shel; Coyne, Brian J.; Colvin, Lisa Cooper (2015-02-13). Clinical Exercise Electrocardiography. Jones & Bartlett Publishers. p. 14. ISBN 9781284034202.
^ "Valvar Pulmonary Stenosis: Background, Pathophysiology, Epidemiology".
^ ^a ^b "Pulmonary Valve Disease. About Pulmonary valve disease | Patient". Patient (in en-GB). Retrieved 2015-11-18. CS1 maint: Unrecognized language (link)
^ Choices, NHS. "Congenital heart disease - Treatment - NHS Choices". www.nhs.uk. Retrieved 2015-11-18.
^ "Balloon dilatation of pulmonary valve stenosis | Guidance and guidelines | NICE". www.nice.org.uk. Retrieved 2015-11-18.

External links

Overview at American Heart Association
Animation of pulmonary stenosis from AboutKidsHealth.ca
Echocardiographic assessment of Pulmonary valve stenosis from WikiEcho

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. 経皮的肺動脈弁移植 percutaneous pulmonic valve implantation
5. 三尖弁（TV）閉鎖症 tricuspid valve tv atresia

English Journal

[Cardiofaciocutaneous syndrome, a Noonan syndrome related disorder: Clinical and molecular findings in 11 patients].

Carcavilla A1, García-Miñaúr S2, Pérez-Aytés A3, Vendrell T4, Pinto I5, Guillén-Navarro E6, González-Meneses A7, Aoki Y8, Grinberg D9, Ezquieta B10.
Medicina clínica.Med Clin (Barc).2015 Jan 20;144(2):67-72. doi: 10.1016/j.medcli.2014.06.009. Epub 2014 Sep 4.
OBJECTIVES: To describe 11 patients with cardiofaciocutaneous syndrome (CFC) and compare them with 130 patients with other RAS-MAPK syndromes (111 Noonan syndrome patients [NS] and 19 patients with LEOPARD syndrome).PATIENTS AND METHODS: Clinical data from patients submitted for genetic analysis wer
PMID 25194980

Gargantuan Left Atrium: A Sequela of Mitral Regurgitation and Mitral Stenosis.

Omslaer BT1, Biederman RW.
Echocardiography (Mount Kisco, N.Y.).Echocardiography.2015 Jan 2. doi: 10.1111/echo.12869. [Epub ahead of print]
Cardiac magnetic resonance imaging and echocardiography revealed a gargantuan left atrium measuring 18.9 cm × 15.7 cm × 11.3 cm in a 56-year-old patient diagnosed with severe rheumatic mitral stenosis, severe pulmonary hypertension, and permanent atrial fibrillation. A chest x-ray also reve
PMID 25556297

Decreased left ventricular (LV) function is associated with hip-fractures.

Jansen S1, Koster RW2, de Lange FJ2, Goslings JC3, Schafroth MU4, de Rooij SE5, van der Velde N6.
Archives of gerontology and geriatrics.Arch Gerontol Geriatr.2015 Jan-Feb;60(1):103-7. doi: 10.1016/j.archger.2014.09.002. Epub 2014 Sep 28.
BACKGROUND: Several risk factors for falls and hip-fractures have been recognized, but controversy still exists toward the importance of structural cardiac abnormalities as a potentially modifiable risk factor for recurrent falls. Aim of this study was to determine the association between echocardio
PMID 25442509

Japanese Journal

Restenosis after balloon valvuloplasty in a dog with pulmonary stenosis

SUNAHARA Hiroshi,FUJII Yoko,SUGIMOTO Keisuke,AOKI Takuma,SUGAHARA Gou,SHIROTA Kinji
Journal of Veterinary Medical Science, 2014
… A two-month-old female Chihuahua was diagnosed as severe pulmonary valvular stenosis (PS). … Postmortem examination revealed markedly thickened pulmonary valve due to the increase of extracellular matrix which might be produced by increased α smooth muscle actin-positive myofibroblasts. … The thickening of the valve was associated with restriction of the valve's motion, resulting in restenosis in the present case. …
NAID 130004690857

心室中隔欠損症が合併した重度肺動脈弁狭窄症に対しバルーン弁口拡大術を実施した犬の1例

茂崎宇十沙,藤井洋子,砂原央 [他],高野裕史,青木卓磨
日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 67(7), 512-517, 2014
3カ月齢のイタリアン・グレイハウンドが心雑音の精査を目的に来院した．各種検査の結果，肺動脈弁狭窄症及び筋性部心室中隔欠損症と診断した．肺動脈弁狭窄症は重度であり右室圧の亢進（肺動脈血流速：7.15m/s，推定圧較差：204.5mmHg）により，心室中隔欠損孔を介する短絡血流は右─左方向を呈し，酸素飽和度は93％であった．心室中隔欠損症よりも肺動脈弁狭窄症の病態が予後因子として重要であると判断し，治 …
NAID 130004684493

Overview of the 78th Annual Scientific Meeting of the Japanese Circulation Society:– Cardiology in the Information Era: From Bench to Community –

Watanabe Masafumi
Circulation Journal, 2014
… The most popular sessions included those on "Transcatheter Aortic Valve Implantation for Aortic Stenosis," "Diabetes Mellitus", "Atrial Fibrillation", "Pulmonary Hypertension", and "Diuretics To Treat Heart Failure". …
NAID 130004677632

Related Pictures

★リンクテーブル★

リンク元	「肺動脈弁狭窄症」「pulmonary stenoses」
関連記事	「pulmonary」「valve」「valve stenosis」

「肺動脈弁狭窄症」

Pulmonary valve stenosis
	Pulmonary valve stenosis
Classification and external resources
Specialty	Cardiology
ICD-10	I37.0, I37.2, Q22.1
ICD-9-CM	424.3, 746.02
OMIM	265500
MedlinePlus	001096
eMedicine	emerg/491

　　[★]

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

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)