Quadricuspide pulmonary valve seen in 3D, 2D, M-mode and Doppler. Pulmonary stenosis.

1. 3D TRANSTHORACIC ECHO:
QUADRICUSPID PULMONARY VALVE

2. PV PV
2D TRANSTHORACIC ECHO: QUADRICUSPID
PULMONARY VALVE

3. PULMONARY VALVE M-MODE: THERE IS OPENING OF THE VALVE WITH
ATRIAL CONTRACTION SHOWING THAT PULMONARY ARTERY PRESSURE IS
TOO LOW, THAN >>>> PULMONARY STENOSIS
M-MODE IS ALIVE!

4. YES, THERE IS FLOW DURING ATRIAL CONTRACTION THROUGH THE PULMONARY VALVE

5. PULMONARY FLOW, GRADIENT OF 29 mmHg. BUT IT IS BEING UNDERESTIMATED.
HOW DO WE KNOW? 1) BECAUSE OF THE M-MODE FINDINGS AND 2) THE SIGNS THAT
THE PULMONARY JET IS NOT ALIGN (SEE ARROW) any question, ask why?

6. PULMONARY FLOW DOPPLER USING THE SUBCOSTAL VIEW. STILL NOT PERFECTLY ALIGNED.
41 mmHg BETTER NOW, BUT YET UNDERESTIMATED.

7. END
FERNANDO MORCERF, MD.