Cardiac Path Online

Pathology of Pulmonary Valve Disease

Dr Sampurna Roy MD




- Pulmonary Stenosis : 

1. Congenital (Tetralogy of Fallot):

2. Rheumatic

3. Carcinoid Heart Disease

- Pulmonary Incompetence :

1. Functional

2. Rheumatic

3.Infective Endocarditis

4. Carcinoid Heart Disease

5. Trauma

6. Congenital


Rheumatic :

In the adult pulmonary stenosis is extremely  rare as an isolated lesion and usually involves the other cardiac valves as well.

Carcinoid Heart Disease:

The carcinoid syndrome with release of vasoactive peptides into the circulation results in fibrosis of the right-sided valve cusps of both pulmonary and tricuspid valves.

Which usually look as if wax has been poured over them resulting in a white coating (carcinoid plaque) usually on the ventricular surfaces.

The left- sided valves can also be involved occasionally.

Microscopic features :  The plaques are composed of mainly smooth muscle cells and some collagen fibers, embedded in an acid mucopolysaccharide matrix.

The lesion is thought to be due to serotonin (5 HT), which is inactivated during the passage of blood through the lungs by the monoamino oxidase present in the pulmonary vascular endothelium.

Further reading:

Carcinoid heart disease.

Infective endocarditis of bicuspid pulmonary valve.

Isolated pulmonic valve endocarditis.  

Prognosis of carcinoid heart disease: analysis of 200 cases over two decades.

Factors associated with progression of carcinoid heart disease.

Carcinoid heart disease: impact of pulmonary valve replacement in right ventricular function and remodeling.

Tricuspid and pulmonary valve involvement in carcinoid disease.





Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)







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