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Bicuspid Pulmonic Valve
Journal of the American College of Cardiology © 2009 by the American College of Cardiology Foundation Published by Elsevier Inc.
Vol. 54, No. 8, 2009 ISSN 0735-1097/09/$36.00 doi:10.1016/j.jacc.2009.05.027
IMAGES IN CARDIOLOGY
Bicuspid Pulmonic Valve Rajesh Vedanthan, MD, MPH, Javier Sanz, MD, Jonathan Halperin, MD New York, New York
From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, New York. Manuscript received April 23, 2009; accepted May 14, 2009.
A
53-year-old woman with hypertension and stage IV Hodgkin’s lymphoma was referred to a cardiologist when pulmonary artery enlargement was detected on computed tomography imaging. The patient had no symptoms referable to the chest. Physical examination revealed an early systolic ejection click and grade 2/6 systolic murmur at the upper left sternal border. The electrocardiogram revealed normal sinus rhythm without features of right ventricular or right atrial abnormalities. Cardiac magnetic resonance imaging confirmed a bicuspid pulmonic valve with anterior and posterior commissures, with a mildly restricted opening (A, left: end-diastolic; right: end-systolic, Online Video 1). On contrast-enhanced magnetic resonance angiography, the tubular portion of the pulmonary trunk appeared aneurysmal (B). There were no other congenital anomalies. Bicuspid pulmonic valve is a rare congenital disorder usually associated with other congenital heart defects. Isolated bicuspid pulmonic valve is exceedingly rare, and the clinical course is usually benign, requiring no therapeutic intervention in the absence of significant obstruction or insufficiency of the valve.
Vol. 54, No. 8, 2009 ISSN 0735-1097/09/$36.00 doi:10.1016/j.jacc.2009.05.027
IMAGES IN CARDIOLOGY
Bicuspid Pulmonic Valve Rajesh Vedanthan, MD, MPH, Javier Sanz, MD, Jonathan Halperin, MD New York, New York
From the Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai Medical Center, New York, New York. Manuscript received April 23, 2009; accepted May 14, 2009.
A
53-year-old woman with hypertension and stage IV Hodgkin’s lymphoma was referred to a cardiologist when pulmonary artery enlargement was detected on computed tomography imaging. The patient had no symptoms referable to the chest. Physical examination revealed an early systolic ejection click and grade 2/6 systolic murmur at the upper left sternal border. The electrocardiogram revealed normal sinus rhythm without features of right ventricular or right atrial abnormalities. Cardiac magnetic resonance imaging confirmed a bicuspid pulmonic valve with anterior and posterior commissures, with a mildly restricted opening (A, left: end-diastolic; right: end-systolic, Online Video 1). On contrast-enhanced magnetic resonance angiography, the tubular portion of the pulmonary trunk appeared aneurysmal (B). There were no other congenital anomalies. Bicuspid pulmonic valve is a rare congenital disorder usually associated with other congenital heart defects. Isolated bicuspid pulmonic valve is exceedingly rare, and the clinical course is usually benign, requiring no therapeutic intervention in the absence of significant obstruction or insufficiency of the valve.