肺動脈弁狭窄症
WordNet
- abnormal narrowing of a bodily canal or passageway (同)stricture
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/07 17:30:43」(JST)
[Wiki en表示]
Pulmonic stenosis, also known as Pulmonary stenosis, is a dynamic or fixed obstruction to 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 may be due to subvalvular or supravalvular (Stenosis of pulmonary artery) obstruction. It may occur in association with more complicated congenital heart disorders.
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Contents
- 1 Pathophysiology
- 2 Prognosis & Treatment
- 3 References
- 4 External links
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Pathophysiology[edit]
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.
Prognosis & Treatment[edit]
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[edit]
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- 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[edit]
- Pulmonary stenosis information for parents.
UpToDate Contents
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English Journal
- Transcatheter aortic valve implantation via surgical subclavian versus direct aortic access: A United Kingdom analysis.
- Myat A, Papachristofi O, Trivedi U, Bapat V, Young C, de Belder A, Cockburn J, Baumbach A, Banning AP, Blackman DJ, MacCarthy P, Mullen M, Muir DF, Nolan J, Zaman A, de Belder M, Cox I, Kovac J, Brecker S, Turner M, Khogali S, Malik I, Redwood S, Prendergast B, Ludman P, Sharples L, Hildick-Smith D.
- International journal of cardiology. 2020 Jun;308()67-72.
- Surgical subclavian (SC) and direct aortic (DA) access are established alternatives to the default transfemoral route for transcatheter aortic valve implantation (TAVI). We sought to find differences in survival and procedure-related outcomes after SC- versus DA-TAVI. We performed an observational c
- PMID 32247575
- Degenerative Mitral Stenosis Versus Rheumatic Mitral Stenosis.
- Pressman GS, Ranjan R, Park DH, Shim CY, Hong GR.
- The American journal of cardiology. 2020 May;125(10)1536-1542.
- Mitral stenosis is classically caused by rheumatic disease (RMS). However, degenerative mitral stenosis (DMS) is increasingly encountered, particularly in developed countries with aging populations. The aim of this study was to compare clinical and echocardiographic characteristics between the 2 ent
- PMID 32241552
- Haploinsufficiency of the basic helix-loop-helix transcription factor HAND2 causes congenital heart defects.
- Cohen ASA, Simotas C, Webb BD, Shi H, Khan WA, Edelmann L, Scott SA, Singh R.
- American journal of medical genetics. Part A. 2020 May;182(5)1263-1267.
- Congenital heart defects (CHDs) are caused by a disruption in heart morphogenesis, which is dependent, in part, on a network of transcription factors (TFs) that regulate myocardial development. Heterozygous sequence variants in the basic helix-loop-helix TF gene heart and neural crest derivatives ex
- PMID 32134193
Japanese Journal
- Pulmonary Arterial Hypertension Associated With Tetralogy of Fallot
Related Links
- Overview Pulmonary valve stenosis is a condition in which a deformity on or near your pulmonary valve narrows the pulmonary valve opening and slows the blood flow. The pulmonary valve is located between the lower right heart ...
- Pulmonic stenosis is common in dogs and infrequent in cats. It results in obstruction to right ventricular outflow due, in most cases, to dysplasia of the pulmonic valve cusps. Although the valvular form is most common, stenosis can ...
★リンクテーブル★
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- 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
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
重症度
- a peak systolic transvalvular pressure gradient
- >50 mmHg : mild
- 50< < 80 mmHg : moderate
- > 80 mmHg : severe
症状
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)
参考
- 1. [charged] Clinical manifestations and diagnosis of pulmonic stenosis - uptodate [1]
国試
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- 関
- pulmonary valve