Adult Congenital Heart Disease -1 : Pulmonary Valve Stenosis

Pulmonary Valve Stenosis
Pulmonary Valve Stenosis

This is a timed quiz. You will be given 600 seconds to answer all questions. Are you ready?

600

All of the following are TRUE regarding valvular PS EXCEPT -

Correct! Wrong!

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

Commonest cause of pulmonary valve stenosis –

Correct! Wrong!

ANSWER -B
Most common cause of pulmonary valve stenosis is congenital heart disease

All of the following are indicators of increased severity of PS in ejection murmur EXCEPT –

Correct! Wrong!

ANSWER -D
As the severity of PS increases, the ejection murmur increases in intensity, its duration prolongs, and its peak becomes more delayed.

What % of the patients with tetralogy of Fallot have associated Peripheral pulmonary stenosis:

Correct! Wrong!

ANSWER -C
20 % of the patients with tetralogy of Fallot have associated Peripheral pulmonary stenosis

What is the treatment of choice for pulmonary valve stenosis in symptomatic domed valve patients –

Correct! Wrong!

ANSWER -A
PULMONARY VALVE STENOSIS - Percutaneous balloon valvuloplasty is highly successful in domed valve patients and is the treatment of choice.

Noncongenital postoperative pulmonic valvular stenosis is seen in –

Correct! Wrong!

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.

Sinus of Valsalva aneurysms can cause Pulmonic Stenosis by –

Correct! Wrong!

ANSWER -D
Sinus of Valsalva aneurysms and aortic graft aneurysms are extracardiac entities that can cause PS by external compression.

Most common congenital heart disease associated with Noonan Syndrome –

Correct! Wrong!

ANSWER -D
Pulmonary valvular stenosis (50–60%)
Atrial septal defects (10–25%)
Ventricular septal defects (5–20%)
Hypertrophic cardiomyopathy (12–35%)

Congenitally bicuspid pulmonary valves are associated most commonly with which of the following -

Correct! Wrong!

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.

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

Correct! Wrong!

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.

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