ACQUIRED PULMONARY STENOSIS - ULTRASONOGRAPHIC DIAGNOSIS

A 15-year-old boy presented with chest pain and a new heart murmur. Th e clinical diagnosis of pulmonary stenosis was confirmed by two-dimens ional and Doppler echocardiographic examinations. A large, encapsulate d, partly solid and partly cystic tumor in the anterior mediastinum, v isualized by ultrasonography, was compressing the main pulmonary arter y and producing the right ventricular outflow tract obstruction. The t umor was removed surgically and was found to be a benign teratoma. Pos toperative ultrasound examination of the right ventricular outflow tra ct showed no evidence of obstruction. We conclude that: (1) there are subtle clinical diagnostic differences between intrinsic and extrinsic pulmonary stenosis; (2) ultrasound examination can make cardiac cathe terization unnecessary; and (3) relief of the extrinsic cause of pulmo nary stenosis should be curative.