Diagnostic Considerations

Caution should be taken when an infant or child presents with symptoms of severe outflow tract obstruction. Failure to diagnose a serious congenital heart defect, such as tetralogy of Fallot (TOF) has a possibility of yielding disastrous consequences. Cyanotic patients with TOF and mild right ventricular outflow tract obstruction may have a similar presentation and physical examination findings.^[15]Echocardiography can reliably differentiate between pulmonic valvular stenosis and TOF.

Other conditions to consider in patients with suspected pulmonic valvular stenosis include the following:

Complex congenital heart disease associated with findings of pulmonary stenosis
Infundibular/subinfundibular stenosis
Supravalvular pulmonary stenosis
Dysplastic pulmonic valve stenosis
Pediatric tachycardia

Differential Diagnoses

Workup

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Victoria Zaccone, MD Resident Physician, Departments of Emergency Medicine and Internal Medicine, Kings County Hospital, SUNY Downstate Medical Center

Victoria Zaccone, MD is a member of the following medical societies: American College of Physicians, American Medical Student Association/Foundation, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Coauthor(s)

Bobak Zonnoor , MD, MMM Assistant Professor of Emergency Medicine, SUNY Downstate School of Medicine; Director, ED Observation Unit, Department of Emergency Medicine, Kings County Hospital; Volunteer Assistant Clinical Professor, University of California, Los Angeles, David Geffen School of Medicine; Clinical Faculty, University of California, Riverside, School of Medicine

Bobak Zonnoor , MD, MMM is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents' Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Program Director, Emergency Medicine, Einstein Medical Center Montgomery

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

David Eitel, MD, MBA Associate Professor, Department of Emergency Medicine, York Hospital; Physician Advisor for Case Management, Wellspan Health System, York

David Eitel, MD, MBA is a member of the following medical societies: American College of Emergency Physicians, American Society of Pediatric Nephrology, Society for Academic Emergency Medicine, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Mert Erogul, MD Assistant Professor of Emergency Medicine, University Hospital of Brooklyn: Consulting Staff, Department of Emergency Medicine, Kings County Hospital Center

Mert Erogul, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Allysia M Guy, MD Staff Physician, Department of Emergency Medicine, State University of New York Downstate Medical Center

Disclosure: Nothing to disclose.

Kurt Pflieger, MD, FAAP Active Staff, Department of Pediatrics, Lake Pointe Medical Center

Kurt Pflieger, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Emergency Physicians, American Heart Association, and Texas Medical Association

Disclosure: Nothing to disclose.

David J Wallace, MD, MPH Resident, Assistant Professor of Clinical Medicine, Departments of Emergency Medicine and Internal Medicine, Kings County Hospital.

David J Wallace is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, Society for Academic Emergency Medicine, and Society of Critical Care Medicine.

Disclosure: Nothing to disclose.