User:Mr. Ibrahem/Pulmonary valve insufficiency

Pulmonary valve insufficiency, also known as pulmonary regurgitation, is a type of valvular heart disease in which there is backward flow of blood from the pulmonary artery, through the pulmonary valve, into the right ventricle, when the heart relaxes. Most people have no symptoms. When symptoms do occur these may include shortness of breath with exercise, leg swelling, and an enlarged liver. Complications may include heart failure, ventricular arrhythmia, and tricuspid insufficiency.

Causes may include pulmonary hypertension, surgical valvulotomy, balloon valvuloplasty, carcinoid syndrome, infective endocarditis, rheumatic heart disease, or congenital valve disease. It commonly occurs in people with tetralogy of Fallot as the surgery to correct the abnormality can result in pulmonary valve issues years later. The diagnosis may be suspected based on a diastolic murmur and confirmed by an ultrasound of the heart.

Yearly ultrasounds may be recommended in those at risk. In those with pulmonary hypertension, that should be treated. In those with symptoms, pulmonary valve replacement may be recommended. The tricuspid valve may benefit from being repaired at the same time. In those unable to have surgery, diuretics, ACE inhibitors, and beta-blockers may be used to treat heart failure. Outcomes can be good with surgery.

Severe pulmonary valve insufficiency is rare. A small to moderate amount of back flow may normally occur. The murmur of pulmonary valve insufficiency was first described in 1873 by George Balfour and later in 1888 by Graham Steell. It was further described by William Osler in 1892, at which time it was considered of little importance.