Severe Congenital Pulmonary Valve Stenosis Diagnosed in Adulthood: A Case Report

Figures

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  Figure 1. Electrocardiographic Findings in Severe Pulmonary Valve Stenosis Twelve-lead electrocardiogram showing right axis deviation and features consistent with right ventricular hypertrophy, including tall R waves in the right precordial leads and deep S waves in the lateral leads. These findings reflect chronic right ventricular pressure overload secondary to severe pulmonary valve stenosis.

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  Figure 2. Posteroanterior Chest Radiograph Showing Left Pulmonary Artery Dilatation A prominent left pulmonary artery segment (red arrow) is seen, consistent with post-stenotic pulmonary artery dilatation in the setting of severe pulmonary valve stenosis. No signs of pulmonary congestion are observed.

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  Figure 3. Continuous-Wave Doppler Echocardiography Demonstrating Severe Pulmonary Valve Stenosis. A markedly increased transvalvular flow velocity is seen, with a peak velocity of 4.53 m/s and a maximum systolic gradient of 82.23 mmHg, consistent with severe pulmonary valve stenosis. The Doppler profile reflects significant right ventricular outflow tract obstruction.

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  Figure 4. Apical Four-Chamber TTE Showing Right Ventricular Hypertrophy Right ventricular hypertrophy (red arrow) is seen with preserved cavity size. The left-sided cardiac chambers appear normal. These findings reflect chronic right ventricular pressure overload secondary to severe pulmonary valve stenosis. RV: right ventricle; LV: left ventricle; RA: right atrium; LA: left atrium; TTE: transthoracic echocardiography

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  Figure 5. Sagittal CTPA Showing Post-Stenotic Dilatation of the Left Pulmonary Artery Marked dilatation of the left pulmonary artery (red arrow) is seen, consistent with post-stenotic pulmonary artery dilatation secondary to severe pulmonary valve stenosis. No evidence of pulmonary embolism or associated aortic coarctation is observed. CRPA: computed tomography pulmonary angiography

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  Figure 6. Axial CTPA Showing Left Pulmonary Artery Dilatation Marked dilatation of the left pulmonary artery (red arrow) is seen, consistent with post-stenotic pulmonary artery dilatation in the setting of severe pulmonary valve stenosis. No intraluminal filling defects suggestive of pulmonary embolism are observed. CTPA: computed tomography pulmonary angiography