Cardiac Center

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?

When the heart squeezes, the right ventricle (the lower right chamber) pumps blood out into the pulmonary artery, the artery that takes blood to the lungs. The pulmonic or pulmonary valve is located between the right ventricle and the main pulmonary artery to prevent blood from leaking back into the heart 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 mild, moderate or severe.

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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 feeling tired, fainting with exercise or other activity, abnormal heart rhythms, or a heart murmur (an extra heart sound when a doctor listens with a stethoscope).

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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:

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What are the treatment options for pulmonary regurgitation?

If the regurgitation is mild, treatment is usually not necessary. Mild pulmonary regurgitation is  very 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 insertion of an artificial pulmonary valve, which can be done either by a surgeon or a cardiologist.

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What kind of follow-up care is required for pulmonary regurgitation?

Through 18

Children with moderate or severe 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.

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Contact us

Contact the Cardiac Center at The Children's Hospital of Philadelphia for a second opinion or for more information.

Reviewed by: Paul Stephens Jr., MD
Date: November 2013

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