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Tests and diagnosis
By Mayo Clinic staffPulmonary stenosis is often diagnosed in childhood, but sometimes it isn't detected until later in life. Your doctor may suspect pulmonary stenosis if he or she hears a heart murmur in the upper left area of your chest during a routine checkup. Your doctor may then use a variety of tests to confirm the diagnosis:
- Electrocardiogram. An electrocardiogram records the electrical activity in your heart each time it contracts. During this procedure, patches with wires (electrodes) are placed on your chest, wrists and ankles. The electrodes measure electrical activity, which is recorded on paper. This test helps determine if the muscular wall of your right ventricle is thickened (ventricular hypertrophy).
- Echocardiography. Echocardiograms use high-pitched sound waves to produce an image of the heart. Sound waves bounce off your heart and produce moving images that can be viewed on a video screen. This test is useful for checking the structure of the pulmonary valve, the location and severity of the narrowing (stenosis), and the function of the right ventricle of your heart.
- Other imaging tests. Magnetic resonance imaging and CT scans are sometimes used to confirm the diagnosis of pulmonary valve stenosis.
- Cardiac catheterization. During this procedure, your doctor inserts a thin flexible tube (catheter) into an artery or vein in your groin and weaves it up to your heart or blood vessels. A dye is injected through the catheter to make your blood vessels visible on X-ray pictures. Doctors also use cardiac catheterization to measure the blood pressure in the heart chambers and blood vessels. This test is generally only done when doctors suspect that you or your child will need balloon valvuloplasty to treat your pulmonary valve stenosis, because that procedure can be done at the same time as cardiac catheterization.
References
- Keane MG, et al. Clinical manifestations and diagnosis of pulmonic stenosis, http://www.uptodate.com/home/index.html. Accessed Sept. 10, 2009.
- Pulmonic stenosis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec07/ch076/ch076h.html. Accessed Sept. 14, 2009.
- Harris IS, et al. Congenital heart disease in adults. In: Crawford MH. Current Diagnosis and Treatment: Cardiology. 3rd edition. New York, N.Y.: McGraw-Hill; 2009. http://www.accessmedicine.com/content.aspx?aID=3649722. Accessed Sept. 16, 2009.
- What is heart valve disease? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/hvd/hvd_all.html. Accessed Sept. 14, 2009.
- Bittl JA. Natural history and treatment of pulmonic stenosis. http://www.uptodate.com/home/index.html. Accessed Sept. 10, 2009.
- Carcinoid syndrome. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec12/ch161/ch161b.html. Accessed Sept. 19, 2009.
- ACC/AHA 2008 guidelines for the management of adults with congenital heart disease. Washington, D.C. and Dallas, Tex.: American College of Cardiology and American Heart Association. Journal of the American College of Cardiology. 2008;52:e143.
