legacy pulmonology :: Article CreatorGeneral Pulmonology
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What To Know About Pulmonary Valve Stenosis
Pulmonary valve stenosis can be both congenital (present at birth) or something adults develop later on in life. It can range in severity from mild to severe cases. Often, a person may not know they have the condition until years down the road.
In a substantial amount of cases, the patient is able to go through life without any major issues. In moderate cases, some medical procedures may be required. It is common to see the doctor every few months in order to monitor the success of the procedures.
In some severe cases, surgery is required, and physical activity is restricted until the patient shows signs of improvement.
Pulmonary valve stenosis (PVS) is a condition that affects the heart. The heart has the important job of maintaining proper blood flow throughout our bodies. It needs to remain strong and functioning for us to maintain good health.
The heart is a muscle that contains four chambers:
The left atrium (top left) The right atrium (top right) The left ventricle (bottom left) The right ventricle (bottom right) After its journey through the body, blood is pumped back into the heart. From there, it enters the right side. It goes from the right atrium into the right ventricle, then through the pulmonary valve. Then, it receives fresh oxygen from the lungs and continues through the body once more.
Picture the pulmonary valve as a one-way door. It has small flaps that allow blood to flow through it one way, with no way of getting back.
In people with pulmonary valve stenosis, the blood has a hard time making its way through the pulmonary valve. This is usually because the valve is too narrow.
The heart has its own way of dealing with this issue. Because it has to work extra hard to force blood through that small opening, it does what any other muscle might do when it gets overworked: become larger and thicker. Unfortunately, this can put a strain on heart function.
PVS isn't a disease; it's an abnormality that usually happens during the heart's development. Doctors don't know the exact cause of PVS, but it isn't caused by anything a mother did or didn't do during her pregnancy.
PVS can be present on its own or alongside other heart defects. Some known causes of PVS include:
Rubella infection of the mother during pregnancy can cause PVS in the baby William's syndrome, a genetic disorder that causes a child developmental delays, can also cause PVS Who is at risk of developing this condition? Most people who have it are born with it. Babies' heart valves form during the first 8 weeks of pregnancy, so it's possible that this condition could be passed genetically from parent to child.
If a mother gets rubella, also known as German measles, during pregnancy, there is a higher chance the baby will develop pulmonary valve stenosis.
The illness can also occur if a baby has Noonan syndrome. Noonan syndrome is a genetic condition that is typically passed down from parent to child. It can cause short stature, unusual facial characteristics, and heart development issues.
In adults, rheumatic fever and carcinoid syndrome can put you at risk of getting pulmonary stenosis. Both these diseases can cause damage to your heart valves.
Williams syndrome is a rare disorder few babies are born with. It's characterized by certain facial features that get more pronounced with age and slow mental development. People born with Williams syndrome, also called Williams-Beuren syndrome, are at risk of developing PVS among other heart defects.
In some mild cases of valve stenosis, you might not notice symptoms at all. You may go for a routine check-up, and your doctor might find it when they listen to your heart with a stethoscope.
Symptoms of severe pulmonary valve stenosis in babies may also manifest, though, in an obvious way: They may show some blue coloration (cyanosis).
Some common symptoms of moderate pulmonary valve stenosis can include:
Feeling tired or very short of breath after a short amount of exercise Fast breathing and heart rate A bluish color around the lips and fingertips Fainting Chest pain Swelling in the hands and feet, legs, belly, or face General fatigue Sometimes, symptoms only present during exercise.
Pulmonary valve stenosis can sometimes be diagnosed before birth. A fetal echocardiogram, (also known as a fetal echo) can show pictures of what a fetus' heart looks like while they're still growing inside the mother.
If you suspect that you or your child has pulmonary stenosis, you might visit the doctor, and they will decide which tests to perform. Some of those tests can include:
X-ray. Chest X-rays can show changes to or structural problems within your heart. Echocardiogram. Similar to an imaging test performed on an unborn baby, this test uses sound waves to create pictures of your heart. It is one of the most accurate diagnostic tools. Electrocardiogram (ECG). This test tracks the rhythms of the heart. It can detect areas of stress in the heart and record electrical activity. Cardiac catheterization. Doctors are usually able to diagnose pulmonary stenosis with other tests. A cardiac catheter is more invasive and will usually be used as a last option. A tube is inserted in the groin area and pushed up to the heart. They will check each of the four chambers of the heart for circulation issues and problematic blood pressure. A dye is often used to measure how efficiently the heart is pumping blood. Magnetic Resonance Imaging (MRI). MRI tests can sometimes be ordered depending on what equipment the doctor has available. Before your doctor's visit, write down any symptoms you or your child have experienced. Think of your family's health history and make note of any concerns. Also, write down any questions you have for your doctor.
If you are taking any medications or supplements, make a list and have it readily available.
If you are seeing your general practitioner or family doctor, they will likely perform a general check-up and possibly order an imaging test. Depending on the results of the test, you could be referred to a heart specialist.
If you see a specialist, you might consider gathering some information about how this condition can affect everyday life. For instance, you may ask:
Can you or your child participate in sporting activities or exercise? If so, which ones are safe? What could be a possible cause of this condition? Is there a certain heart rate number you should aim to stay under? Is a heart rate or blood pressure monitor necessary for you? What are the treatment options, and what risks and benefits does each option carry? Are there any additional educational resources such as websites or reading material that could be beneficial? The doctor will have some questions for you too. They could be related to how you or your child are experiencing the symptoms in terms of time duration or what they are doing when the symptoms appear.
In mild cases, no treatment is needed other than regular follow-ups with your doctor. If the symptoms are moderate to severe and are interfering with your quality of life, you might consider the following treatment options:
Balloon valvuloplasty. An un-inflated balloon is placed on the end of a catheter and brought into the small heart valve using imaging tests as a guide. The balloon is then inflated, stretching the pulmonary valve open. This is one of the most common treatments. It's possible that the valve can return to its original size after the treatment. Pulmonary valve replacement. The heart valve can be replaced by undergoing surgery. An artificial valve or donor valve is used. This procedure is performed on a case-by-case basis and depends on other factors the patient might be going through. Valvotomy. If there is scar tissue on the pulmonary valve causing less blood to flow through, corrective surgery can be performed to remove the scar tissue. It's important to remember that although the valve may function normally after surgery, it will need to be monitored regularly, and precautions must be taken during some medical procedures.
Complications can arise whether you've had corrective treatment or not. For example, if you undergo a valve replacement, there are several safeguards you must have in place to prevent inflammation or infection of the valve.
Endocarditis is one such risk. It's a bacterial infection that settles into the lining of the heart. It can be especially threatening to someone who's had heart surgery or has a heart condition.
Most people who have had valve replacement surgery will need to take antibiotics before any dental or medical procedures in order to prevent endocarditis.
Other complications of pulmonary valve stenosis can be:
The heart muscle thickens. Because the heart has to work harder to pump blood, the walls of the heart can get thick. This can cause extra strain on the heart. Irregular heartbeat. Also known as arrhythmia, this can happen in people with valve stenosis. In severe cases, your doctor might recommend treatment. Heart failure. In severe cases, the heart could fail because it's working extremely hard to pump blood, and not enough blood is going through it. Pregnancy complications. If you have pulmonary valve stenosis, it can interfere with your pregnancy. It depends on the severity of your case and how the health of your heart valve has been maintained. 'Owlman' Clarence Cameron Has Died, Leaving A Legacy Of Art, Community And Kindness
The longtime Madison artist known as the "Owlman," who also created an organization to unify Wisconsin visual artists and craftspeople and co-founded the popular summer and winter Art Fairs Off the Square, died Monday at age 83.
Clarence Cameron passed away 14 weeks to the day after losing his partner of nearly 63 years and husband since 2013, retired architect Bob Lockhart. The two were known as inseparable and were profiled in publications such as the Wisconsin State Journal and Our Lives magazine for their long and supportive relationship.
Madison couple Bob Lockhart and Clarence Cameron married this month in Vermont, a step they thought impossible when they met in the early 1960s.
"Bob and Clarence moved into their house on Cedar Street in 1971, and turned it into a lovely home for living, working, and entertaining their many friends through the years," a close friend and neighbor, Laurel Kinosian, wrote on Facebook in announcing Cameron's passing.
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"As younger people move into our Bay Creek neighborhood, they can do no better than to look to Clarence and Bob as role models in how to be good friends and neighbors."
A native of Beloit and a familiar face in South Madison for six decades, Cameron attended mortuary school and worked in a funeral home and as a physical therapist's assistant, until he opened the Double C Ceramic Shop on South Park Street in 1965. The business was a success and remained open for nine years before Cameron turned to working as an artist full time.
Clarence Cameron talks with a Wisconsin State Journal reporter in his Bay Creek home in 2015.
JOHN HART, STATE JOURNAL ARCHIVES
At art shows across the country, ceramic owls were his best sellers — until he started carving the birds out of lumps of soapstone, a stone that gets its name for its slippery texture when wet and became one of Cameron's signature materials. With soapstone, the artist first used a rasp to create a general shape, then intricately carved the piece into a unique image — both elegant and intriguing — using dental tools and his father's old pocketknife. Detailed patterns in the stone emerged as Cameron polished each owl with fine steel wool.
"It really is strange," Cameron said in a 2006 profile in the State Journal. "The stone says, 'This is what I am.'" And when the image is complete, "The stone really says, 'You've carved me enough. You don't need to go any further.'"
Lasting legacy
The striking sculptures earned him a spot year after year in the prestigious "Birds in Art" show at Wausau's Leigh Yawkey Woodson Art Museum, a showcase of some of the world's finest wildlife artists. Cameron, who through his work became an amateur expert in owls and other birds, was a signature member of Artists for Conservation, an international organization of artists who serve as ambassadors for the environment. His artworks have been featured in the "Atlas of North American Birds — Owls."
He founded the Wisconsin Alliance of Artists and Craftspeople, a nonprofit organization of more than 350 professional artists and craftspeople from across the state, and in 1980 co-founded Madison's annual Art Fair Off the Square, held alongside the Madison Museum of Contemporary Art's Art Fair on the Square and featuring exclusively Wisconsin artists. Its winter counterpart, held indoors at Monona Terrace each holiday season, soon followed. Both WAAC and the art fairs are thriving to this day.
Cameron and Lockhart always had several pet parrots who took up residence in cages in their living room. After Lockhart passed away, their African grey parrot Nigel would frequently ask, "Where's Bob?," said Sandra Higgins, a close and longtime family friend. Cameron would reply, "'Bob's not here, but he's still with us.'"
After Cameron's death, "it was a little bit eerie," Higgins said. Nigel would repeat the phrase about Bob "in Clarence's voice." Higgins is now caring for Nigel and Cameron's other Timneh grey parrot, Sierra.
Cameron became part of her family after he and Higgins' dad, a Madison art teacher, became close friends, Higgins said.
"Clarence and I had art, my mom and dad, and birds in common," she said. "Clarence was the Owlman and the bird man."
Lockhart died in late February. At a memorial service held a few months later at the Frank Lloyd Wright-designed First Unitarian Society auditorium, the tall and lanky Cameron, wearing a dark suit and his signature black ponytail, greeted each attendee in his typically friendly and chatty manner.
"He was an amazing artist, with a lot of vision and insight," said silk-painter Mary Ellen Johnson, vice president of WAAC and a friend of Cameron's for more than 30 years.
"He knew about a lot of things — and he had opinions about a lot of things. He always had a smile on his face, and those sort of crinkled eyes when he'd be talking to you. He'd be really animated."
'Warm and caring person'
To his Bay Creek neighborhood, Cameron was known for posting on the neighborhood listserv information about wild birds in the area, updates on his partner's health, offers of free Madison Symphony Orchestra tickets and more, often with the subject line "CLARENCE WHOO?"
Clarence Cameron carves owl sculptures from soapstone in his basement in 2006.
STATE JOURNAL ARCHIVES
As Cameron cared for Lockhart in his husband's last days and then struggled with his own cancer and chronic obstructive pulmonary disease, neighbors rallied around him, said Higgins, who is helping to organize a memorial service for Cameron later this year, most likely in late summer or early fall at First Unitarian Society.
"That whole neighborhood really pulled together beautifully to take care of both Bob and Clarence as they got older and started to have health issues, which was a very wonderful thing," she said. "Clarence has mucho friends."
Friends on Facebook speculated that Cameron died of a broken heart.
When Lockhart died, "Clarence had a hard time accepting this," Higgins said. "He missed Bob so bad. The one thing I would never, ever question is that they loved each other so much. It was so clear."
A "warm and caring person," Cameron "lived his life with grace and confidence," said artist and friend Karen Ann Hoffman. "Clarence was a living example of knowing one's purpose and living it to the fullest."
Bob Lockhart, left, and Clarence Cameron make their way to a weekly yoga class for seniors at a community center just a few blocks from their home on Madison's South Side in 2013.
JOHN HART, STATE JOURNAL ARCHIVES Be the first to know
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