Heart and Blood Conditions
What is pulmonary stenosis?
Pulmonary stenosis (pronounced PULL-mun-airy sten-OH-sis) is a heart condition in which the pulmonary valve cannot open completely. The pulmonary valve is the one-way door that allows blood to flow from the right ventricle of the heart to the lungs, where it picks up oxygen.
Because the pulmonary valve cannot open all the way, the right ventricle must pump harder to move the blood from the heart to the lungs. As a result, the right side of the heart may get larger and thicker.
Pulmonary stenosis may be the only heart problem a child has, or it may be part of a more complicated heart condition.
Pulmonary stenosis is a congenital problem with the pulmonary valve.
There is a wide range of severity. A newborn or young infant with severe pulmonary stenosis can be quite sick. Children with mild pulmonary stenosis may have no symptoms. Most children with the condition are healthy and have no symptoms at all.
Pulmonary stenosis can become worse with time. Most children with this problem see a cardiologist for years.
We don’t know why the pulmonary valve develops abnormally in some babies. Genetics may play a role. For example, pulmonary stenosis often occurs in patients with Noonan syndrome.
Pulmonary stenosis can also occur later in life as a result of some other condition that damages the heart valves, such as rheumatic fever.
Pulmonary Stenosis at Seattle Children’s
U.S. News & World Report consistently ranks Seattle Children’s cardiology and heart surgery program as one of the best in the country. With more than 40 pediatric cardiologists, we have experience diagnosing and treating every kind of heart problem.
Not all children with pulmonary stenosis require treatment. If it is needed, our team has expertise in the treatment of this condition in infants, children and adolescents. We see many children each year with this problem. Often, children with pulmonary stenosis need cardiac catheterization. Less commonly, the condition requires surgery.
Seattle Children’s has been treating children since 1907. Our team members are specially trained in their fields and in meeting the unique needs of children. For example, the doctors who give your child anesthesia are board certified in pediatric anesthesiology. This means they have extra years of training in how to take care of kids. Our child life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
When you come to Seattle Children’s, a team of people will take care of your child. Along with your child’s heart doctor (cardiologist), we have newborn specialists (neonatologists), lung doctors (pulmonologists), nurses, child life specialists, social workers and others available, if their expertise is needed. We also have a pediatric cardiac anesthesia team and a Cardiac Intensive Care Unit ready to care for children who undergo heart surgery.
We’re committed to your child’s overall health and well-being. We’ll help your family through this experience and discuss treatments in ways you can understand and involve you in every decision.
Symptoms of Pulmonary Stenosis
Some children with pulmonary stenosis do not have any symptoms at first. They may have no noticeable problems unless the condition gets worse. If they have symptoms, these may get worse with exercise or activity.
Babies may have symptoms like these:
- Working hard to breathe
- Poor appetite
- Trouble feeding
- Failure to thrive
- Blue appearance in the mouth and gums or in the fingernails and toenails (cyanosis)
Newborns with these symptoms need treatment right away.
Children past infancy may also have these symptoms:
- Feeling short of breath when active
- Having pain, pressure or tightness in their chest
- Fainting or feeling weak or dizzy when active
- Being more tired than normal
Diagnosing Pulmonary Stenosis
To diagnose this condition, your doctor will examine your child, use a stethoscope to listen to their heart and check their blood pressure. Sometimes, doctors find pulmonary stenosis after hearing heart murmurs in a child who appears well.
The doctor will ask for details about any symptoms your child has, their health history and your family health history.
Your child will need an echocardiogram test so the doctor can see how their heart works.
They may need other tests that provide more information about their heart. These include:
Treating Pulmonary Stenosis
Not all children with pulmonary stenosis need treatment. It depends on how severe their condition is. But all children with this condition need lifelong care to monitor their condition in case it starts to get worse.
Some children with pulmonary stenosis need treatment right away because their heart cannot deliver enough blood and oxygen to the rest of their body.
To meet your child’s long-term healthcare needs, we have a special Adult Congenital Heart Disease Program to transition your child to adult care when they’re ready.
Treatment options for pulmonary stenosis
If the stenosis is mild, sometimes your child may not need any kind of treatment, surgery or medicine.
If the stenosis is more severe, treatment may be done in the catheterization lab using a balloon procedure. A balloon is inserted across the valve. When the balloon is inflated, the valve is stretched open. Then, the balloon is removed. This is called balloon valvuloplasty.
Some children need surgery to open the valve and increase blood flow to the lungs. If the stenosis is severe enough, your child may need their valve replaced.
Contact the Heart Center at 206-987-2015 for a cardiac referral, a second opinion or more information.