Parasternal long axis pulm valve | Pediatric Echocardiography

Pulmonary Stenosis
- Pulmonary valve stenosis with flow turbulence starting at the level of the pulmonary valve

Pulmonary Valve Stenosis
- Dysplastic pulmonary valve with thickened and tethered leaflets which dome in systole

Pulmonary Valve Stenosis
- Continuous wave Doppler across the pulmonary valve revealing severe pulmonary valve stenosis
- Mild dynamic obstruction (dagger-like Doppler signal buried within parabolic Doppler signal)

Echocardiographic Assessment: Parasternal Long Axis
- Profile the distal right ventricular outflow tract/subvalvar region (2D, color Doppler, spectral Doppler)
- Assess the pulmonary valve for dysplasia (leaflet morphology, excursion, hypoplasia, tethering)
- Assess main pulmonary artery (hypoplasia, post-stenotic dilation in case of valvar PS)
- Assess for pulmonary stenosis or regurgitation (color and spectral Doppler pulse wave and continuous wave Doppler) at the subvalvar, valvar and supravalvar level

Transducer placed at the left sternal border
3rd or 4th intercostal space
Notch pointed towards patient's right shoulder
Angle transducer anteriorly towards patient's left shoulder (tilt tail of transducer down)