Pulmonary stenosis with increased pulmonary blood flow

Abstract

1. 1. Eight cases of pulmonic stenosis with increased pulmonary blood flow have been described. Four cases had an interventricular septal defect, three an atrial septal defect and one, an aortic-pulmonary artery communication. 2. 2. Such cases are not rare since they occur at least as frequently as instances of Eisenmenger's syndrome. 3. 3. The essential clinical features consist of a combination of the signs of an atrial or an interventricular septal defect associated with those of a pulmonic stenosis. Increased pulmonary vascular markings which are seen by x-ray caused the pulmonic stenosis to be overlooked in seven of the above eight cases. In five cases the pulmonic second sound was accentuated. 4. 4. Surgery should be directed toward closure of the septal defect where this is possible since the degree of pulmonic stenosis is usually mild and further enlargement of the valve orifice may only increase the magnitude of the left-to-right shunt.