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- Pulmonary Stenosis : Image Link;

Image Link. ; Image Link ; Image Link.

1. Congenital (Tetralogy of Fallot):

2. Rheumatic

3. Carcinoid Heart Disease

- Pulmonary Incompetence : Image Link

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.

Factors Associated with Progression of Carcinoid Heart Disease : NEJM

                 

Abstracts:

Carcinoid heart disease.Curr Cardiol Rep. 2006 Mar;8(2):96-101

Infective endocarditis of bicuspid pulmonary valve.Cardiovasc Pathol. 2006 Mar-Apr;15(2):119-20.

Isolated pulmonic valve endocarditis. Can J Cardiol. 2005 Mar15;21(4) :365-6.

Prognosis of carcinoid heart disease: analysis of 200 cases over two decades.Circulation. 2005 Nov 22;112(21):3320-7. Epub 2005 Nov 14.

Factors associated with progression of carcinoid heart disease.N Engl J Med. 2003 Mar 13;348(11):1005-15

Carcinoid heart disease: impact of pulmonary valve replacement in right ventricular function and remodeling.Circulation. 2002 Sep 24;106(12 Suppl 1):I51-I56.

Tricuspid and pulmonary valve involvement in carcinoid disease.Tex Heart Inst J. 2000;27(4):405-7.


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