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What is Pulmonary Regurgitation?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 16 November 2016
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Pulmonic or pulmonary regurgitation is a heart condition that suggests that the pulmonary valve is not efficiently doing its job. The valve’s function is to open and close, allowing blood to pass into the pulmonary artery, then to the lungs. If this valve, which is attached to the right ventricle, is somehow compromised, it can fail to close properly, and blood will flow back into the right ventricle. Over time, the right ventricle may enlarge and pump less efficiently, and people can experience many symptoms that ultimately can lead to right heart failure.

There are many potential causes of pulmonary regurgitation. A number of congenital heart defects that are either great or small may show a degree of this symptom. Even repairs of complex heart defects may leave a residual and acceptable amount of regurgitation and certain repairs, like pulmonary valve replacements as they age, may show higher and higher levels of this. Other causes of regurgitation, more often present in adults, include pulmonary hypertension or bacterial endocarditis.

The symptom of mild forms of pulmonary regurgitation may be non-existent, or so minor they evade detection. As the condition worsens, symptoms become more obvious. They can include cyanosis (blueness, particularly of the extremities), difficulty breathing, fatigue, fluid accumulation at places like the ankles and possibly in the abdomen, and a distinct and detectable heart murmur.

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To better diagnose this condition, cardiologists usually perform a number of tests. An echocardiogram easily shows the blood leaking back into the right ventricle. X-rays can point to any fluid accumulation. An electrocardiogram (EKG) is useful in detecting heart rhythm issues associated with pulmonary regurgitation. Another test that may be used is cardiac catheterization, which can also measure the level of pulmonary hypertension, if it is a causal factor.

There are a number of ways to treat pulmonary regurgitation, and treatment depends on underlying cause and severity. Very minor cases of it may be monitored only to see if they worsen. Some medications can be used to minimize symptoms of heart failure and improve right heart function. The other option is surgical, which means repairing or replacing the pulmonary valve.

For many heart defects, where pulmonary regurgitation is most severe, valve replacement is the best option. It typically means that people will need additional replacements in the future. Sometimes the leaflets of the pulmonary valve can be repaired instead, and this is considered a first option when possible, since it leaves the valve intact.

Most with a compromised pulmonary valve or with one that has been replaced or repaired can live a very normal life in most instances. One of the major complications that may occur if regurgitation is present, or if valve surgery has occurred, is that people are much more vulnerable to bacterial endocarditis. This most frequently occurs if people don’t use prophylactic antibiotics prior to dental work. With the exception of this issue, many people who have even valve replacements have few restrictions, but underlying conditions like pulmonary hypertension, may remain an influential factor in overall wellness.

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