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Pathology
Incompetent pulmonary valve allowing backflow of blood into right ventricle
Aetiology
Pulmonary hypertension, infective endocarditis, carcinoid, post pulmonary valve
Surgery, connective tissue disease, Tetralogy of Fallot
Signs
Right ventricular heave, raised JVP, Loud and delayed P2 heart sound. Graham Steell murmur
Symptoms
Usually asymptomatic or symptoms of right heart failure
Investigations
ECG: Right ventricular hypertrophy and right bundle branch block
Chest X-Ray: Large pulmonary trunk
Echo: Enlarged right ventricle with reduced function, may show tricuspid regurgitation
Treatment
Medical: Salt restriction and treat pulmonary hypertension
Surgical: Valve replacement or percutaneous pulmonary valve implantation
Prognosis
Surgery improves outcome
Heart failure, valve failure, infective endocarditis and thromboembolic events
Key Facts
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Key Images
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Key References
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