What is the diagnosis of pulmonary stenosis in infants?

When pulmonary valvular stenosis is mild, there are generally no symptoms. Patients with severe cases often show symptoms such as palpitations, fatigue, and even chest tightness. In the later stages, they often have a decreased appetite and their lower limbs are submerged in water. In general, pulmonary valvular stenosis is relatively common in infants. Many parents may not know much about pulmonary valvular stenosis in infants. Let me share with you how to diagnose pulmonary valvular stenosis in infants.

Pulmonary valve stenosis in children is a type of congenital heart disease. According to medical statistics, the incidence of simple pulmonary valvular stenosis accounts for about 7% of congenital heart disease. In the early stages of pregnancy, the pulmonary valve is obstructed and deformed due to certain factors during embryonic development, leading to stenosis of the pulmonary valve orifice. As a result, the right ventricle is resisted from radiating blood to the pulmonary artery, which increases the systolic pressure, causing right ventricular myocardial hypertrophy, decreased pressure in the pulmonary artery, and reduced blood volume in the pulmonary circulation.

The severity of clinical symptoms in children with pulmonary valvular stenosis is closely related to the degree of pulmonary valvular stenosis. If the child with pulmonary artery stenosis is of mild type, there are often no abnormal symptoms and physical development is normal, and the disease is often discovered during physical examinations. Some children do not show symptoms until they are young and middle-aged, such as fatigue, shortness of breath, palpitations, and rapid heartbeats after exercise or physical labor. Children with more severe pulmonary valvular stenosis often experience shortness of breath, fatigue, and sometimes chest pain after activities. In more serious cases, cerebral hypoxic syncope may occur (due to a significant decrease in pulmonary blood volume, leading to cerebral hypoxic-ischemic syncope). When the doctor examines the patient, a rough and loud systolic murmur of grade 3 or above can be heard in the second intercostal space on the left side of the sternum. The characteristic of this murmur is that it is transmitted to the left neck and back. When you touch the murmur with your hand, you may feel a cat's wheezing sensation. In medicine, this phenomenon is called palpable tremor. You can also hear a significant decrease in the second pulmonary artery sound. Based on the above symptoms and characteristics of heart murmurs, doctors can preliminarily diagnose pulmonary valve stenosis.

1. Chest X-ray examination: The upright protrusion of the pulmonary artery segment is the characteristic manifestation of this disease. The right ventricle may also be enlarged to varying degrees, with sparse vascular shadows at the hilum of the lung and clear lung fields.

2. Electrocardiogram examination: right ventricular hypertrophy and right bundle branch block may appear.

3. Echocardiography: It can observe the degree and thickness of pulmonary valve stenosis and understand the changes in hemodynamics.

To further clarify the diagnosis, electrocardiogram, chest X-ray, and echocardiography are required. Since the pulmonary valve is the most difficult valve to examine during this examination, it may not be helpful in diagnosing the degree and location of valvular stenosis. Therefore, patients with moderate or severe pulmonary valve stenosis must undergo a right cardiac catheter examination. The right cardiac catheter examination can measure the pressure and display the pressure gradient between the right ventricle and the pulmonary artery sound. This can accurately diagnose the degree of pulmonary valve stenosis and provide a reliable basis for surgical treatment of children with moderate or severe pulmonary valve stenosis.

Through my description of the diagnosis of infant pulmonary valvular stenosis above, I believe parents have gained a new understanding. If a baby has pulmonary valvular stenosis, it is necessary to go to a regular hospital for examination as soon as possible and receive treatment under the doctor's advice and guidance. In addition, pay more attention to accompanying the baby on a daily basis and pay attention to the baby's diet, eating small meals frequently, which will help with treatment. I wish you good health.