Clinical features
- usually asymptomatic, presenting only with a murmur.
- if severe obstruction, the cardiac output may be reduced and exertional syncope occasionally can result.
- longstanding obstruction may result in right ventricular failure and therefore necessitate a high filling pressure - right atrial pressure.
- patient appears normal unless there is a recognisable syndrome in association.
- pulse and blood pressure are normal.
- JVP - a large a wave signifies atrial hypertrophy.
- may be a parasternal heave due to right ventricular hypertrophy - and maybe a thrill in the pulmonary area.
- auscultation:
- pulmonary ejection click - the click disappears on inspiration in severe stenosis.
- a loud pulmonary ejection murmur - loudest to left of upper sternum, with radiation to the left shoulder.
- second heart sound - with significant obstruction the P2 is delayed and soft.
Related pages
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.