Pulmonary stenosis

Incidence
Age
Sex
Geography
Aetiology	- usually congenital lesion - may rarely be due to rheumatic fever or the carcinoid syndrome - valvular, sub-valvular or supra-valvular
Presentation	- right ventricular hypertrophy -> right atrial hypertrophy - fatigue, syncope, symptoms of right heart failure - harsh mid-systolic ejection murmur; best heart in second intercostal space on left edge of sternum ± thrill - right ventricular heave - right ventricular fourth sound and prominent jugular venous a-wave in moderate stenosis
Investigations	CXR - prominent pulmonary artery ECG - right atrial and right ventricular hypertrophy Cardiac catheterization - measurement of systolic pressure gradient across pulmonary valve
Macro
Micro
Staging
Serum Markers
Management	- pulmonary valvotomy in severe stenosis - ballon or direct surgery
Prognosis
Complications