Diagnosis

The definitive diagnostic test for pulmonic stenosis is:

1. Doppler echocardiography
2. Cardiac catheterization

A presumptive diagnosis can be made with:

1. Auscultation of a left basilar systolic heart murmur
2. Normal femoral arterial pulse
3. Right ventricular enlargement on ECG and
4. Right ventricular enlargement on radiography
5. Main pulmonary artery bulge on radiographs
6. Radiology may show:
   • right ventricular enlargement
   • bulge in the main pulmonary artery
   • ascites
   • hepatomegaly
7. ECG may show:
   • normal ECG
   • right ventricular enlargement criteria with moderate to severe pulmonic stenosis
   • right atrial enlargement
   • may be normal with mild cases
   • dysrhythmias may be noted
8. Echocardiography:
   • right ventricular hypertrophy
   • stenosis of the pulmonic valve
   • increased velocity of flow across the pulmonic valvular orifice by Doppler
     • Not only does this data provide a diagnosis but it remains the most critical data to address severity of the stenosis
   • pulmonic regurgitation by Doppler
   • right ventricular enlargement
   • tricuspid regurgitation by Doppler