Pathological and clinical manifestations of pulmonary valvular stenosis in newborns

Neonatal pulmonary valve stenosis is also known as congenital heart disease. The main symptoms of the newborn are fatigue, shortness of breath, and palpitations. It is difficult to help solve. It is a breathing difficulty caused by a single malformation. There are many modern methods to determine the diagnosis. It is relatively easy to quickly detect the disease, but there is no effective treatment method. Ensure more rest and ensure smooth breathing. This is the way to deal with it.

1. Etiology and pathology

Pulmonary artery stenosis is a common congenital heart disease as a single malformation, accounting for about 10% to 20% of congenital heart diseases, among which valvular stenosis is the most common, accounting for about 70% to 80%.

The basic hemodynamic changes of pulmonary artery stenosis are obstruction of right heart outflow and increase in right ventricular systolic pressure, leading to right ventricular hypertrophy.

2. Clinical manifestations

Varies depending on the degree of stenosis. Common symptoms include fatigue, palpitations and shortness of breath. Physical examination revealed a loud, rough systolic murmur with thrill at the second intercostal space on the left side of the sternum; the second sound in the pulmonary valve area was normal or decreased; and a jet sound in the pulmonary artery area was heard. Heart murmurs are present at birth and are a characteristic clinical manifestation.

3. Imaging manifestations

1. Typical X-ray manifestations:

(1) The heart is of "mitral" type and slightly enlarged, mainly in the right ventricle.

(2) The pulmonary artery segment is bulging, mostly moderately to highly bulging, and upright. Its upper edge can be close to the level of the aortic arch.

(3) Pulmonary blood volume is reduced, and the pulmonary vascular texture is thin and sparse, which is in sharp contrast to the obvious protrusion of the pulmonary artery segment. The shadows of the two hilar arteries are asymmetric (left side > right side), which is quite characteristic in diagnosis.

2. Echocardiogram: helps confirm the diagnosis.

3. Magnetic resonance imaging:

Imaging can be performed in any direction and layer to display the main and pulmonary arteries, valve orifices and right ventricular outflow tract, which is very helpful for observing the location, range and degree of stenosis.

4. Cardiovascular angiography:

Right ventricle angiography is appropriate, with frontal and lateral projections. In the early stage of contrast agent injection, the ventricle contracts and a column of blood containing contrast agent can be observed ejected from the stenosis, which is called the "jet sign", and can be used to measure the degree of valve stenosis.

Neonatal pulmonary valve stenosis means that the child has congenital heart disease. With the help of instruments, surgery can help alleviate the pain of the newborn, but the treatment of pulmonary valve stenosis is a long process. For infants with extremely severe pulmonary stenosis, if not treated in time, they can often die in infancy. Therefore, treatment is very important and parents should pay more attention.