Learning Radiology xray montage

Pulmonic Stenosis

• Pulmonic stenosis without VSD= 8% of all CHD

            • Mostly asymptomatic

            • When symptomatic, cyanosis and heart failure

            • Loud systolic ejection murmur

• Cor pulmonale

• Rare calcification of pulmonary valve in older adults


            • Enlarged main pulmonary artery

            • Enlarged left pulmonary artery (jet stream effect)

            • Normal to decreased peripheral pulmonary vasculature

pulmonic stenosis

Pulmonic Stenosis. There is post stenotic dilatation of the main pulmonary artery (red arrow) from valvular pulmonic stenosis. This could be presumed to be a mediastinal mass not of vascular origin. A CT scan would be definitive.

Subvalvular pulmonic stenosis

            •Infundibular pulmonic stenosis

                        • Typically in Tetralogy of Fallot

            •Subinfundibular pulmonic stenosis

                        •Associated with VSD (85%)

Valvular Pulmonic Stenosis

            • Classic pulmonic stenosis (95%)

            • Fusion of pulmonary cusps

            • Presents in childhood

            • Pulmonic click

            • Dome-shaped pulmonic valve

            • RX: Balloon valvulo-plasty

Trilogy of Fallot

            • Severe pulmonic valvular stenosis

            • RV hypertrophy

            • ASD with R—L shunt

Supravalvular pulmonic stenosis

            •May be either tubular hypoplasia or localized with poststenotic dilatation

            •May be associated with:

                        • Valvular pulmonary stenosis, supravalvular aortic stenosis, VSD, PDA, systemic arterial stenoses

                        • Williams-Beuren Syndrome: PS, supravalvular AS, peculiar facies

                        • Ehlers-Danlos syndrome

                        • Postrubella Syndrome: peripheral pulmonary stenoses, PDA, low birth weight, deafness, cataracts, mental retardation