Pulmonary Regurgitation
Before you begin reading about pulmonary regurgitation, please read the explanation of how the normal heart works for a basic understanding of its structure and function.
- What is pulmonary regurgitation?
- What are the symptoms of pulmonary regurgitation?
- How is pulmonary regurgitation diagnosed?
- What are the treatment options for pulmonary regurgitation?
- What kind of follow-up care is required for pulmonary regurgitation?
What is pulmonary regurgitation?
When the heart squeezes, the right ventricle (the lower right chamber) contracts and pushes blood out into the pulmonary artery, the artery that takes blood to the lungs. The pulmonic, or pulmonary, valve sits on the way out of the heart between the right ventricle and the main pulmonary artery to prevent blood from leaking back in between beats.
Pulmonary regurgitation occurs when the pulmonary valve doesn't completely close and allows some blood to leak back into the heart. This condition is also known as pulmonic or pulmonary insufficiency. It can be trivial, mild, moderate or severe.
What are the symptoms of pulmonary regurgitation?
Pulmonary regurgitation often doesn't cause symptoms in infants or children. As the child gets older, abnormal signs and symptoms may appear, including fatigue, fainting with exercise or other activity, arrhythmias, or a heart murmur (an extra heart sound when a doctor listens with a stethoscope).
How is pulmonary regurgitation diagnosed?
We usually diagnose pulmonary regurgitation after a primary care doctor detects a heart murmur and refers a child to the Cardiac Center. Sometimes pulmonary regurgitation results from surgery to correct heart defects such as tetralogy of Fallot.
Diagnosis may require some or all of these tests:
- Pulse oximetry - a painless way to monitor the oxygen content of the blood
- Chest X-ray
- Echocardiogram (also called "echo" or cardiac ultrasound) - sound waves create an image of the heart
- Electrocardiogram (ECG) - a record of the electrical activity of the heart
- Cardiac MRI - a three-dimensional image shows the heart's abnormalities
- Cardiac catheterization - a thin tube is inserted into the heart through a vein and/or artery in either the leg or through the umbilicus ("belly button")
What are the treatment options for pulmonary regurgitation?
If the regurgitation is trivial or mild, treatment is usually not necessary. Trivial pulmonary regurgitation is actually exceedingly common. If the pulmonary valve is normal, there may not even be a need for regular checkups. However, if there is moderate or severe pulmonary regurgitation, doctors will monitor the patient with regular checkups. At this point, medications are not used to help with pulmonary regurgitation itself, although medications may be used to help the heart to pump more efficiently.
Surgery to repair or to replace the valve is often necessary in severe cases. Depending on the age, gender, and particular needs of your child, as well as the valve anatomy, surgeons may attempt to repair the valve, or at least improve its function, with a surgery called a valvuloplasty.
Another option includes the surgical placement of a valve called a pulmonary homograft, which is a donated pulmonary valve and artery. This valve may grow with your child, and your child won't be required to take blood-thinners.
Finally, an exciting future option will be the creation of a new valve from the patient's own cells grown on a biodegradable mesh. This is presently in development and is not yet available.
What kind of follow-up care is required for pulmonary regurgitation?
Through 18
Children with pulmonary regurgitation require regular checkups with a pediatric cardiologist.
Our pediatric cardiologists follow patients until they are young adults, coordinating care with the primary care physicians.
Into adulthood
Pulmonary regurgitation can cause heart problems in adults. It is very important that adults with this condition are monitored by a cardiologist regularly. The Cardiac Center will help with the transition to an adult cardiologist.
The Philadelphia Adult Congenital Heart Center, a joint program of The Children's Hospital of Philadelphia and the University of Pennsylvania, meets the unique needs of adults who were born with heart defects.
Contact us
Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.
Reviewed by: Jeffrey R. Boris, MD
Date: February 2009
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