Highlights & Basics
- Pulmonary regurgitation is incompetency of the pulmonary valve, which results in leakage of blood from the pulmonary artery back into the right ventricle.
- Pulmonary regurgitation may be due to a congenital defect or may be acquired.
- Any disease of the left side of the heart or the lungs that results in significant pulmonary hypertension and dilated pulmonary arteries may lead to acquired pulmonary regurgitation. It may also result from surgical repair of tetralogy of Fallot, pulmonary stenosis, or atresia.
- Isolated pulmonary regurgitation is rarely symptomatic; however, large regurgitant volume in the presence of dilated right ventricle may be associated with exertional dyspnea, easy fatigability, and intermittent chest pain.
- Echocardiography is essential to determine the severity and mechanism of pulmonary regurgitation.
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Definition
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Short axis echocardiographic view in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a restrictive right ventricle, and short axis echocardiographic view reveals that the right ventricle is large
Short axis echocardiographic view in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a restrictive right ventricle, and short axis echocardiographic view reveals a small right ventricle
Doppler echocardiogram in a patient with pulmonary regurgitation following repair of tetralogy of Fallot, revealing a non-obstructed right ventricular outflow tract. The patient has a restrictive right ventricle
Doppler echocardiogram in a patient with pulmonary regurgitation following repair of tetralogy of Fallot, revealing a nonobstructed right ventricular outflow tract. The patient has a nonrestrictive right ventricle
Doppler in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a nonrestrictive right ventricle, and an ''A'' wave is not seen in the pulmonary artery Doppler spectrum
Doppler in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a restrictive right ventricle, and Doppler shows evidence of restriction with an antegrade "A" wave in the pulmonary artery
Chest x-ray in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a restrictive right ventricle and the heart is small
Chest x-ray in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a nonrestrictive right ventricle and the heart is large
Magnetic resonance imaging (MRI) in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a restrictive right ventricle, and MRI shows decreased right ventricular volume
Magnetic resonance imaging (MRI) in a patient with pulmonary regurgitation following repair of tetralogy of Fallot. The patient has a nonrestrictive right ventricle, and MRI shows that the right ventricle is dilated
Citations
American College of Radiology. ACR appropriateness criteria: congenital or acquired heart disease. 2023 [internet publication].[Full Text]
Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2021 Feb 2;77(4):e25-197.[Abstract][Full Text]
Stout KK, Daniels CJ, Aboulhosn JA, et al. 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol. 2019 Apr 2;73(12):e81-192.[Abstract][Full Text]
Baumgartner H, De Backer J, Babu-Narayan SV, et al. 2020 ESC guidelines for the management of adult congenital heart disease. Eur Heart J. 2021 Feb 11;42(6):563-645.[Abstract][Full Text]
Bokma JP, Geva T, Sleeper LA, et al. Improved outcomes after pulmonary valve replacement in repaired tetralogy of Fallot. J Am Coll Cardiol. 2023 May 30;81(21):2075-85.[Abstract][Full Text]
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