Moderate Pulmonary Valvular Stenosis

Parasternal long axis with anterior tilt in order to visualize the RV outflow tract. One may appreciate that there is a thick doming pulmonary valve that opens but not to the full extent.

Graident from the apical view yields 45 mmHg, which yields this stenosis as "moderate".

Severity

• Mild: Peak gradient <36 mm Hg 

• Moderate: Between 36 and 64 mm Hg 

• Severe stenosis: >64 mm Hg

• Critical stenosis: Inadequate anterograde flow through RVOT. Prostaglandin-E1 dependent for pulmonary blood flow. 

• Reference: https://www.ncbi.nlm.nih.gov/books/NBK560750/ and https://pmc.ncbi.nlm.nih.gov/articles/PMC10320808/ 

Other B-Mode views and Colour views of the RVOT:

Apical views