Overview
Pulmonary regurgitation (PR) describes the inadequate closure of the pulmonary valve leading to the backflow of blood during diastole. The pulmonary valve normally separates the right ventricle and pulmonary artery. It occurs rarely as a congenital abnormality.
Causes
- Congenital
- Rheumatic fever
- Infective endocarditis
- Pulmonary hypertension and its causes
- Marfan syndrome
Presentation
PR is generally asymptomatic. Features include:
- An early diastolic murmur in the left upper sternal edge that is louder on inspiration
- Right-sided heart failure – results in systemic congestion:
- Peripheral oedema, classically ankle or sacral oedema
- Raised jugular venous pressure
- Hepatomegaly which may be pulsatile
- Weight gain due to fluid retention
- Anorexia
Investigations
Overview
- ECG:
- May show right ventricular hypertrophy
- Chest X-ray:
- May show right ventricular hypertrophy
- Echocardiogram:
- Identifies PR
Management
Overview
Management may involve observation, treatment of heart failure, and surgery including pulmonary valve replacement and a heart-lung transplant.
Complications
- Right-sided heart failure
- Infective endocarditis
- Arrhythmia
