Pulmonary Stenosis.

Definition.—Pulmonary stenosis is an obstruction of the pulmonary opening of the right ventricle, due to congenital defects or to endocarditis.

Etiology.—The narrowing of the pulmonary orifice is generally due to congenital malformation, though endocarditis after birth may occasionally give rise to it.

Pathology.—There is generally fusion of the valve segments, leaving but a small opening, the valves not infrequently being covered with vegetations. Hypertrophy of the .right ventricle naturally follows, to compensate the closure and maintain the pulmonary circulation.

Symptoms.—As in pulmonary insufficiency, the general symptoms are obscure and the physical signs uncertain. A systolic murmur, attended with a thrill, may be heard in the second right intercostal space to the left of the sternum. Other pulmonic murmurs, however, are to be heard, and the distinction is often not clear. The murmur of aortic stenosis, however, may be excluded, for it is transmitted to the cervical vessels, while the aforesaid systolic murmur is not.

Diagnosis.—As in pulmonary insufficiency, a positive diagnosis can only be made post-mortem.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.