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pulmonic regurgitation (pulmonary valve regurgitation)
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 distension
- 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
Related
pulmonic valve (valve of pulmonary trunk)
tetralogy of Fallot
General
pulmonic valve disease
References
- Medical Knowledge Self Assessment Program (MKSAP) 15, 16, 17.
American College of Physicians, Philadelphia 2009, 2012, 2015