Pulmonary Regurgitation

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Pulmonary regurgitation is also called pulmonic regurgitation or PR. This condition is extremely common, and at some point will affect anywhere from 30-75% of the population. Most of the time, it’s very mild and doesn’t cause symptoms or require treatment. But when symptoms become severe, there are multiple treatment methods available.

Treating Pulmonary Regurgitation at UVA Health

While medications can be used to reduce the symptoms of PR, addressing the valve is the only way to correct the disorder. There are a couple of options for this, in addition to traditional valve replacement.

Right Ventricle to Pulmonary Artery Conduit

A valved conduit is placed to supply blood flow to the lungs. This procedure is usually done to correct congenital heart defects. While useful, it’s not uncommon for patients to eventually experience issues with their conduit.

Percutaneous Pulmonary Valve Insertion

For patients who have a failed conduit, as described above, the Melody valve is a new procedure performed at UVA Health.

This procedure eliminates the need for open heart surgery. Instead, a new valve is inserted through a catheter in the leg.

Inserting the Melody valve is only a one-to-two hour procedure, and only requires an overnight hospital stay. You can read more about the Melody valve procedure here, or read about one patient’s experience with Melody here.

What Is Pulmonary Regurgitation?

The pulmonary valve regulates blood flow from the right side of the heart to the lungs. When it doesn’t close properly, some of the blood leaks back into the right side of the heart. This causes the right side of the heart to work harder to push the blood out. Over time, this can cause the right ventricle to become damaged and lead to heart failure.

What Are the Symptoms of Pulmonary Regurgitation?

Mild cases of PR may present with no symptoms at all. For most, symptoms come on gradually and get worse over time.

Symptoms may include:

  • Difficulty breathing and fatigue, especially during exercise
  • Chest pain, such as squeezing, pressure or tightness
  • Sensation of rapid or irregular heartbeat (palpitations)
  • Swelling of the legs or feet
  • Dizziness or fainting
  • Bluish discoloration of the nails and lips (cyanosis)

Who Is at Risk?

One of the most common causes for pr is pulmonary hypertension. Pulmonary hypertension can be caused by lung disease, sickle cell anemia, and genetics. But it can also have no cause at all. 

Other risk factors for PR include:

  • Tetralogy of Fallot (a congenital heart defect)
  • Endocarditis
  • Rheumatic fever

What If I Have Trivial Pulmonary Regurgitation?

Trivial pulmonary regurgitation is a frequent finding. In these cases, there is no need to intervene. Follow-up with your doctor regularly to make sure the condition is not worsening.

Preventing PR

Keep your heart and lungs as healthy as possible can help reduce your risk of PR and pulmonary hypertension, the major cause of PR.

  • Manage high blood pressure
  • Avoid smoking

How Is Pulmonary Regurgitation Diagnosed?

Many of the symptoms of PR can be found in a simple physical exam during your annual check-up.

These symptoms include:

  • Abnormal chest sounds, such as a heart murmur
  • Distention of the jugular vein in the neck
  • Enlargement of the liver
  • Retention of fluid in the ankles

After discussing your family history, symptoms, and medical history, your doctor may order some tests.

Tests may include: