What Is Pulmonary Regurgitation?

The pulmonary valve is one of four valves within the heart. It delivers blood from the heart into the lungs. When the pulmonary valve does not fully close, blood can flow back into the heart before it goes into the lungs to gather oxygen. This is called pulmonary regurgitation.

Approximately 2.5% of the U.S. population suffers from valvular heart disease and it is typically found in older adults. Pulmonary valve regurgitation accounts for up to 20% of heart valve disease.

This article will provide an overview of pulmonary regurgitation and discuss the symptoms, causes, and treatments available.

Pulmonary Regurgitation Symptoms

Pulmonary regurgitation can happen quickly but typically occurs slowly over time. Some pulmonary regurgitation symptoms include:

• Shortness of breath
• Chest pain
• Fatigue
• Dizziness or fainting
• Fever
• Rapid weight gain
• Irregular heartbeat
  

Causes

The most common cause of pulmonary regurgitation is pulmonary hypertension, a condition that causes increased pressure in the pulmonary artery (the vessel that carries blood from the heart to the lungs). This prevents the pulmonary valve from adequately closing, which sends blood back into the heart instead of to the lungs for oxygen, resulting in pulmonary regurgitation.

Other causes of pulmonary regurgitation include:

• Endocarditis (an infection of the heart)
• Complications after surgery for Tetralogy of Fallot (a type of congenital heart disease)
• Rheumatic fever (an inflammatory disease)

Diagnosis

For an official pulmonary regurgitation diagnosis, it is important to have a complete evaluation performed by a healthcare professional, such as a primary care provider or a cardiologist (heart specialist).

Your provider will complete a thorough medical history and physical examination. They will check your heart and listen for a heart murmur, which may help them determine the heart valve that is causing the symptoms.

Additional testing might be performed, including:

• Electrocardiogram (EKG): An EKG might indicate heart enlargement due to the pulmonary regurgitation, allowing blood to backflow into the right ventricle.
• Echocardiogram: An echocardiogram is an ultrasound of the heart, which can show malfunction of the pulmonary valve and right ventricle enlargement.
• Angiography: A healthcare provider, usually a cardiologist, injects contrast into a catheter fed into the heart to assess the function of the pulmonary valve.
• Cardiac magnetic resonance: This imaging test can determine the severity of the pulmonary regurgitation and the dilation (opening) in the pulmonary artery from the increased pressures.

Treatment

Treatment of pulmonary regurgitation is identifying a cause, which for most patients is pulmonary hypertension. Depending on the severity of the pulmonary regurgitation, treatment options will vary and could include:

• Medications might be used to manage symptoms and alleviate stress on the heart's right ventricle.
• Surgery is an option if the heart or pulmonary valve has structural issues caused by underlying disease or damage.

If the underlying condition is a structural issue with the heart or pulmonary valve, surgery is the most likely option. Surgery may also be recommended if the damage to the pulmonary valve is extensive due to constant increased pressure from pulmonary hypertension.

Prognosis

Prognosis depends on the severity of the pulmonary regurgitation. For mild to moderate pulmonary regurgitation, there is no significant impact to survival rates. In severe pulmonary regurgitation, there tends to be increased strain on the right ventricle, which causes abnormal heart rhythms and right ventricle failure. Severe complications can lead to an increased risk of cardiac death.

Summary

Pulmonary regurgitation is a condition in which the pulmonary valve allows blood to flow back into the right ventricle instead of into the lungs for oxygen. Pulmonary regurgitation is commonly caused by pulmonary hypertension, but can also be caused by other underlying diseases or damage.

Treatment and prognosis both depend on the severity of the pulmonary regurgitation. Generally, when diagnosed early, treatment can prevent heart damage and lead to an optimistic prognosis.

A Word From Verywell

A diagnosis of a heart condition can be overwhelming and scary. Being informed about pulmonary regurgitation, including available treatment options, can help you feel confident in developing an effective treatment plan with your healthcare provider. The goal is to ensure that you are well-informed and able to live the healthiest life possible.