Valvular pulmonic stenosis with intact ventricular septum and patent foramen ovale; report of illustrative cases and analysis of clinical syndrome

In this malformation the difficulty in sending blood through the stenosed pulmonary valve leads to right heart enlargement and to functional patency of the foramen ovale, through which a venousarterial shunt occurs. The onset of symptoms and their severity depend on the size of the opening in the pulmonary valve. Characteristic physical findings and results of fluoroscopy, electrocardiogram, circulation time, arterial blood studies, exercise test, angiocardiogram, and cardiac catheterization are presented. Diagnosis is important because these patients develop cardiac failure following at Blalock-Taussig operation, but may be greatly helped by pulmonic valvulotomy.