Pulmonic Regurgitation

Question 1

What are the PATHOLOGIC CAUSES of PR?

Answer 1

1. Dilated annulus due to PHT
2. Dilated annulus due to chamber enlargement (RV/PA)
3. Congenital
4. PA catheter..critical care, bedside
5. Other: endocarditis, myxomatous, rheumatic, carcinoid

Question 2

What is the MOST COMMON pathologic cause?

Answer 2

dilated annulus due to PHT

Question 3

What are the SIGNS & SYMPTOMS of PR?

Answer 3

usually asymptomatic

if severe: signs of overload to right heart and cava

-Jugular venous distension
-Peripheral edema
-Hepatomegaly
-Ascites

Question 4

What type of AUSCULTATION is heard with PR?

Answer 4

Blowing holodiastolic murmur at upper LSB

Question 5

Severe PHT is clearly distinguishable and referred to as a

Answer 5

graham steel murmur

Question 6

What are the TREATMENTS of PI?

Answer 6

-Well tolerated, if severe - valvuloplasty in terms of repair/replacement

Question 7

What are the 2D FINDINGS of PI?

Answer 7

1. anatomic changes/ abnormalities at valve if present
2. RVH
3. RVE
4. RAE
5. fine diastolic flutter on TV
6. pulmonary artery dilation
7. PSM, D shaped LV in diastole

Question 8

What is evidence of PHT?

Answer 8

RVH

Question 9

What are the COLOR/DOPPLER FINDINGS of PI?

Answer 9

1. Red to candle flame diastolic jet into RVOT
2. Box shaped envelope above baseline during diastole

Question 10

What findings indicate SEVERE PI?

Answer 10

1. prominent holodiastolic flow reversal in PA
2. presence of PISA
3. premature opening of PV
4. increased antegrade velocity
5. PR Index < .77