Case 013 - Pulmonary Stenosis
A 28-year-old female with a history of uncorrected congenital heart disease reports occasional palpitations and mild dizziness on exertion. The symptoms do not disturb the patient; since childhood she has been advised to avoid high-level physical activity but otherwise has led a normal life. At presentation the patient is acyanotic; a loud harsh systolic murmur is heard in the second right intercostal space and her blood pressure is 130/80 mm Hg. No shortness of breath or episodes of syncope are reported, but the index of suspicion for pulmonary stenosis was raised.
Pulmonary stenosis is:
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<p>Valvular with additional subvalvular dynamic obstruction.</p>
How should the patient be managed?
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<p>Balloon valvuloplasty.</p>
A 28-year-old female with a history of uncorrected congenital heart disease reports occasional palpitations and mild dizziness on exertion. The symptoms do not disturb the patient; since childhood she has been advised to avoid high-level physical activity but otherwise has led a normal life. At presentation the patient is acyanotic; a loud harsh systolic murmur is heard in the second right intercostal space and her blood pressure is 130/80 mm Hg. No shortness of breath or episodes of syncope are reported, but the index of suspicion for pulmonary stenosis was raised.
Pulmonary stenosis is:
Valvular.
Supravalvular.
Infundibular.
Valvular with additional subvalvular dynamic obstruction.
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<p>Valvular with additional subvalvular dynamic obstruction.</p>
How should the patient be managed?
Balloon valvuloplasty.
Surgical valvotomy.
Conservatively, follow-up until significant symptoms develop.
Medical treatment with calcium antagonists, ACE Inhibitors, or beta-blockers.
View the correct answer.
<p>Balloon valvuloplasty.</p>
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