Summary

• Any disease of the left side of the heart or the lungs that results in significant pulmonary HTN and dilated pulmonary arteries may lead to acquired pulmonary regurgitation. Pulmonary regurgitation may also be due to a congenital defect.
• Acquired pulmonary valve regurgitation also typically results from surgical repair of tetralogy of Fallot, pulmonary stenosis, or atresia.
• Isolated pulmonary regurgitation is rarely symptomatic; however, large regurgitant volume in the presence of dilated right ventricle may be associated with exertional dyspnoea, easy fatigability, and intermittent chest pain.
• Trans-thoracic echo, trans-oesophageal echo, and MRI are essential to determine the severity and mechanism of pulmonary regurgitation.
• In symptomatic patients with severe regurgitation, pulmonary valve replacement should be considered.