Congenital pulmonary stenosis

Lowance, Mason I.; Jones, Eugenia C.; Matthews, Warren B.; Dunstan, Edgar M.

doi:10.1016/0002-8703(48)90459-1

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…In 13 carefully described cases in the literature who developed heart failure'6, 17, 20-22, 24 (Cases 4, 6, 8-10) 26-28 the type of failure encountered was almost exclusively that of chronic congestion of the viscera with hepatomegaly, ascites, and edema. In none was there evidence of pulmonary congestion except agonally or where pulmonary or left ventricular pathology could have been responsible.2" 24 (Case8) ,25, 26'28Precordial pain has been observed by us frequently in patients with the tetralogy of Fallot, but none of our patients with simple pulmonic stenosis complained of chest discomfort, although it has been reported by others.6' 17,21 Physical examination of our patients showed that they had a normal development. This would obviously be a variable finding, depending on the severity of the stenosis during the growing period.…”

Section: Reportsmentioning

confidence: 58%

“…The lungs have been reported to be singularly free of evidence of chronic passive congestion at autOpsy' 5-17, 20, 22-24, 26-28 and in three instances '21, 24 (Case 8), 25 in which this finding has been described, it appeared from the description to be an agonal complication. Chronic passive congestion of the viscera is the usual finding in those dying in heart failure", 17,20,24 (Cases 4, 7-10) 25. 27 and in this respect tallies xvell with the clinical findings.…”

Section: Electrocardiographic Findingsmentioning

confidence: 71%

“…Right axis deviation has been the usual electrocardiographic finding in simple pulmonic stenosis15' 17,24 (Cases 4 and 9), 25, 27 and right bundle branch block has been reported At least twelve leads were taken in our 8 cases, including the three standard leads, three unipolar limb leads (augmented technic with resistances retained), and six unipolar chest leads after the manner of Wilson.34 In selected cases additional leads including the ensiform Lead VE and one or more leads to the right of V1 (V3R and so forth) were also taken. In all 8 cases the duration of the P-R and QRS intervals was measured and the mean electrical axis and White-Bock axis deviation index calculated.…”

Section: Electrocardiographic Findingsmentioning

confidence: 99%

“…40 In 68 autopsied cases of pure pulmonic stenosis reviewed by Greene and coworkers,' the right ventricle was enlarged in all but 5. The right auricle is often enlarged'6' 17,22,23,24 (Cases 9 and 10), 25, 27 but may be of normal size. 'l 24 (cases 4 and 6) Occasionally enlargement of the left ventricle has been described."…”

Section: Electrocardiographic Findingsmentioning

confidence: 99%

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Studies of Congenital Heart Disease

et al. 1950

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Congenital pulmonic stenosis is indicated by cardiac catheterization by the finding of a higher systolic pressure in the right ventricle than in the pulmonary artery. Eight cases of uncomplicated pulmonic stenosis are studied. The findings on history, physical examination, x-ray and fluoroscopy, and electrocardiogram have been analyzed and the variations in circulatory dynamics encountered in these individuals are described in detail.IT IS generally considered that congenital pulmonic stenosis unaccompanied by other cardiac defects is rare. Recently, Greene and coworkers1 have made a complete review of the literature and have collected 68 cases. Their article and the book of Brown2 contain excellent discussions of this disorder.Cardiac catheterization3 has made possible an accurate recognition of pulmonic stenosis by the finding of a higher systolic pressure in the right ventricle than in the pulmonary artery.4 Pollack, Taylor, Odel, and Burchell5 have recently published a report of 3 cases recognized by this technic, 4 more were reported by Greene and associates', and this paper deals with 8 more cases. METHODSEach patient remained in the hospital for at least four days. A history, physical examination, routine laboratory tests, electrocardiogram, x-ray examination, and fluoroscopy of the heart were carried out. Heart sound tracings were obtained in all cases. On the third day, venous catheterization was performed and the diagnostic routine described elsewhere4 was performed.The circulatory dynamics of 5 of the patients were studied at rest and also under conditions of split. The pulmonic second sound and mitral first sound were of normal intensity. In the third left intercostal space there was a Grade 4, rough, medium-pitched, systolic murmur, stopping just before the second sound. There was an accompanying thrill but no diastolic murmur. The systolic murmur was widely transmitted in diminished intensity over the precordium and faintly over the back. The lungs were clear, abdominal examination normal, radial and femoral pulses were strong, veins were not distended, and no edema could be discerned. TheHinton test 'was negative and urinalysis was normal.The hematocrit was 49 per cent, the hemoglobin 16.5 Gm., the white blood cell count and differential normal, and the routine blood chemistries were normal. X-ray and fluoroscopy revealed a heart of normal size. The pulmonary artery was enlarged and pulsating. The pulmonary vascular markings were within normal limits. The electrocardiogram showed incomplete right bundle branch block.Case 2. R. L. (P.B.B.H. #s6A875) was a 26 year old man in whom a heart murmur had been detected in childhood. He had never had symptoms of rheumatic fever, tuberculosis, or cardiac failure. He had always been fond of sports and was an enthusiastic skier. He had never noticed any decrease in exercise tolerance. Four months before admission, he contracted bacteriologically proven subacute bacterial endocarditis which was treated with penicillin in another city and pronounced cured. Becau...

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Section: Reportsmentioning

confidence: 58%