Pulmonic regurgitation is when blood leaks back into the heart from the pulmonary artery due to weakness in the pulmonary valve.
It happens when a pulmonary valve does not close properly. The pulmonary valve is the mechanism that ensures blood leaving the heart does not come back into it.
Pulmonic regurgitation is not a disease but can result from various conditions, including lung disease, heart failure, and sickle cell disease.
In this article, we look at what pulmonic regurgitation is, why it occurs, and what to expect if it does.
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Pulmonic regurgitation happens when the pulmonary heart valve is faulty and does not seal tightly. The leaky valve allows blood to flow back into the heart’s right ventricle instead of moving on to the lungs to collect oxygen.
The pulmonic or pulmonary valve is one of four heart valves. The others are the tricuspid, the mitral, and the aortic valves.
Other names for regurgitation include backflow and insufficiency.
Pulmonic regurgitation usually results from an underlying condition, such as pulmonary hypertension or a heart defect a person was born with.
The signs and symptoms of pulmonic regurgitation may not appear in the early stages. However, if the underlying disease progresses, a person
- breathlessness, especially on exertion
- fatigue
- swelling in the lower limbs
- a heart murmur, which a doctor can detect
In some cases, pulmonic regurgitation or an underlying cause can lead to heart failure. If this happens, an individual
- palpitations
- chest pain or discomfort
- dizziness
- lightheadedness
Pulmonic regurgitation happens when the valve that allows blood to leave the heart and travel to the lungs becomes leaky.
It
- Pulmonary hypertension and other diseases relating to the blood vessels that serve the lungs, such as:
- chronic thromboembolism of the lungs, chronic obstructive pulmonary disease (COPD), interstitial lung disease, or obstructive sleep apnea
- idiopathic pulmonary arterial hypertension due, for instance, to left heart failure, aortic valve disease, or mitral valve disease
- left heart disease due to sarcoidosis, sickle cell disease, or schistosomiasis
- Pulmonic valve disease, due, for instance, to:
- congenital factors
- heart valve surgery
- endocarditis
- heart cancer
- the use of certain drugs, such as methysergide (Deseril) and fenfluramine (Fintepla)
- rheumatic heart disease
- Enlargement of part of the valve mechanism called the annulus due to:
- pulmonary hypertension
- Marfan syndrome
- repair of a heart defect present at birth known as tetralogy of Fallot
- in some cases, there is no identifiable reason
Risk factors
People
For those who underwent heart surgery as children, pulmonic regurgitation can appear at a young age. Pulmonary hypertension is more likely to affect older adults.
Symptoms do not always appear in the early stages of pulmonic regurgitation, but a doctor may suspect or notice signs of it when investigating an underlying cause.
Tests that
- an electrocardiogram (ECG or EKG)
- an echocardiogram
- an angiogram
- an X-ray to
rule out other causes - a cardiac MRI, known as CMR
- a CT scan
- an exercise stress test
Treatment for pulmonic regurgitation
A person with a lesion or heart defect may benefit from surgery. A doctor may also recommend surgery for severe pulmonary regurgitation, with or without symptoms.
If the condition is not severe enough to warrant surgery, a doctor may prescribe medications to manage pulmonic regurgitation and related conditions, such as:
The outlook for a person with pulmonic regurgitation
Mild to moderate pulmonic regurgitation is unlikely to affect how long a person will live.
However, those with severe pulmonic regurgitation may have an increased risk of:
- an irregular heart rate known as arrhythmia
- worsening heart damage and heart failure
- valve failure
- infective endocarditis
- sudden cardiac death
Surgery can
Pulmonic regurgitation is
Still, some people living with pulmonic regurgitation can benefit from following any treatment plan as advised by their doctor.
People born with a faulty heart valve often have surgery in their early years, which may prevent any future problems. Some, however, may need ongoing monitoring or further treatment later in life.
For those with pulmonary hypertension, a doctor
- supervised moderate exercise
- vaccines to prevent pneumonia, COVID-19, and influenza
- treatment for low iron levels if necessary
- diuretics to manage or reduce fluid retention
Pulmonary hypertension can pose a severe risk during pregnancy. Anyone considering pregnancy should first speak with a doctor.
Here are some questions people often ask about pulmonic regurgitation.
How serious is pulmonic regurgitation?
Mild pulmonic regurgitation is not serious but will likely need monitoring. In time, it can become severe and possibly life threatening.
How do you treat pulmonic regurgitation?
A doctor will start by treating the underlying cause, but they may also prescribe medications such as ACE inhibitors and diuretics if a person has symptoms. In some cases, a doctor may recommend surgery.
Can pulmonic regurgitation cause shortness of breath?
Shortness of breath is one symptom that can occur with pulmonic regurgitation, particularly on exertion. Anyone who has shortness of breath that worsens with exercise should speak with a doctor.
Pulmonic or pulmonary regurgitation is when a leaky valve causes blood to flow back into the heart instead of moving forward to the lungs. It usually results from an underlying condition, such as a congenital heart defect or pulmonary hypertension.
Many people with mild pulmonic regurgitation have no symptoms. If it worsens, however, they may experience breathlessness, fatigue, and other symptoms. Severe pulmonary regurgitation can be life threatening and need medical attention.