pulmonic regurgitation (pulmonary valve regurgitation)

Introduction

Incompetence of the pulmonic valve permitting retrograde flow of blood during diastole.

Etiology

• tetralogy of Fallot
• pulmonary hypertension

Pathology

• back flow of unoxygenated blood from the pulmonary artery into the right ventricle during diastole

Clinical manifestations

• mid diastolic murmur, decrescendo
  • heard best at the left lower sternal border
  • murmur does not radiate
  • murmur increases in intensity with inspiration
  • murmur diminishes in intensity with pulmonary hypertension such that pulmonary artery diastolic pressure approaches RV diastolic pressure
• soft systolic pulmonary outflow murmur
• parasternal right ventricular lift
• jugular venous distention
• lungs are clear to auscultation
• single S2 if the pulmonary valve is sacrificed during repair of Tetralogy of Fallot
• a loud P2 occurs if pulmonary hypertension is present

More general terms

• pulmonic valve disease

Additional terms

• pulmonic valve (valve of pulmonary trunk)
• tetralogy of Fallot