# Severe Congenital Pulmonary Valve Stenosis Diagnosed in Adulthood: A Case Report

## TL;DR

A 21-year-old adult was diagnosed with a rare heart condition called pulmonary valve stenosis, typically found in children, after experiencing breathing difficulties and chest pain.

## Contribution

This case report highlights the rare presentation of congenital pulmonary valve stenosis in adulthood and the challenges of diagnosing and treating it in resource-limited settings.

## Key findings

- Severe pulmonary valve stenosis was diagnosed in a 21-year-old with exertional dyspnea and chest pain.
- Transthoracic echocardiography revealed a peak velocity of 4.53 m/s and a systolic gradient of 82.23 mmHg.
- Balloon pulmonary valvuloplasty was recommended following diagnostic imaging and multidisciplinary evaluation.

## Abstract

Pulmonary valve stenosis is a congenital heart disease that is usually diagnosed during childhood, while presentation in adulthood is uncommon and may lead to delayed diagnosis. We report the case of a 21-year-old patient with no significant medical history who presented with a six-month history of exertional dyspnea and constrictive chest pain. Electrocardiography showed right axis deviation with signs of right ventricular hypertrophy, and chest radiography revealed dilatation of the left pulmonary artery. Transthoracic echocardiography demonstrated severe valvular pulmonary stenosis with a peak velocity of 4.53 m/s and a maximum systolic gradient of 82.23 mmHg, associated with right ventricular hypertrophy and preserved systolic function, without evidence of pulmonary hypertension. Computed tomography pulmonary angiography confirmed focal post-stenotic dilatation of the left pulmonary artery. After a multidisciplinary discussion, balloon pulmonary valvuloplasty was recommended. This case highlights the importance of considering congenital pulmonary valve stenosis in young adults presenting with exertional symptoms and underscores the challenges of access to advanced interventional therapies in resource-limited settings.