Pulmonary regurgitation

Any disease of the left side of the heart or the lungs that results in significant pulmonary hypertension 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 dyspnea, easy fatigability, and intermittent chest pain.

Transthoracic echo, transesophageal echo, and magnetic resonance imaging are essential to determine the severity and mechanism of pulmonary regurgitation.

In symptomatic patients with severe regurgitation, pulmonary valve replacement should be considered.

Pulmonary regurgitation is rare and is infrequently symptomatic. It gradually develops over many years and results in volume overload and right ventricular (RV) dysfunction. It can be congenital or acquired, caused by conditions that increase pulmonary artery pressure, such as left ventricular dysfunction or severe lung disease. The acquired form occurs from any secondary cause that leads to pulmonary regurgitation through increased pulmonary pressure secondary to left-sided failure, or after surgical intervention for tetralogy of Fallot, pulmonary stenosis, or pulmonary atresia. Isolated pulmonary regurgitation occurs as a result of any cause that impacts the valve directly, such as endocarditis. The murmur of pulmonary regurgitation is diastolic and is associated with RV lift.[1]Ansari A. Isolated pulmonary valvular regurgitation: current perspectives. Prog Cardiovasc Dis. 1991 Mar-Apr;33(5):329-44. http://www.ncbi.nlm.nih.gov/pubmed/2003147?tool=bestpractice.com