Adult Congenital Heart Disease -1 : Pulmonary Valve Stenosis
This is a timed quiz. You will be given 600 seconds to answer all questions. Are you ready?
Commonest cause of pulmonary valve stenosis –
ANSWER -B
Most common cause of pulmonary valve stenosis is congenital heart disease
Most common congenital heart disease associated with Noonan Syndrome –
ANSWER -D
Pulmonary valvular stenosis (50–60%)
Atrial septal defects (10–25%)
Ventricular septal defects (5–20%)
Hypertrophic cardiomyopathy (12–35%)
All of the following are indicators of increased severity of PS in ejection murmur EXCEPT –
ANSWER -D
As the severity of PS increases, the ejection murmur increases in intensity, its duration prolongs, and its peak becomes more delayed.
Pulmonary valve stenosis : Which of the following is/are TRUE –
1.P2 delayed
2.Pulmonary ejection click decreases with inspiration
3.Peak pulmonic valve gradients greater than 40 mm Hg should undergo intervention
ANSWER -B
Peak pulmonic valve gradients greater than 60 mm Hg or a mean of 40 mm Hg by echocardiography/Doppler should undergo intervention regardless of symptoms.
What is the treatment of choice for pulmonary valve stenosis in symptomatic domed valve patients –
ANSWER -A
PULMONARY VALVE STENOSIS - Percutaneous balloon valvuloplasty is highly successful in domed valve patients and is the treatment of choice.
What % of the patients with tetralogy of Fallot have associated Peripheral pulmonary stenosis:
ANSWER -C
20 % of the patients with tetralogy of Fallot have associated Peripheral pulmonary stenosis
Congenitally bicuspid pulmonary valves are associated most commonly with which of the following -
ANSWER -C
Bicuspid valve is found in as many as 90% of patients with tetralogy of Fallot, whereas it is rare in individuals with isolated valvar PS.
Noncongenital postoperative pulmonic valvular stenosis is seen in –
ANSWER -B
Ross procedure for aortic valve disease - transfer of the pulmonary valve to the aortic position with a homograft pulmonary valve placed in the pulmonary position.
These patients may develop non-congenital postoperative pulmonic valvular or main pulmonary artery (PA) stenosis due to an immune response in the homograft.
All of the following are TRUE regarding valvular PS EXCEPT -
ANSWER -B
Valvular PS auscultation reveals –
• Normal S1
• Widely split S2
• Soft and delayed P2
• Systolic crescendo-decrescendo ejection murmur in the left upper sternal border that increases with inspiration and radiates diffusely
Sinus of Valsalva aneurysms can cause Pulmonic Stenosis by –
ANSWER -D
Sinus of Valsalva aneurysms and aortic graft aneurysms are extracardiac entities that can cause PS by external compression.
