After completing this article, readers should be able to:

Congenital cardiac malformations that result in obstruction of blood flow from either the right or left ventricle occur at the subvalvular,valvular, or supravalvular level and may exist at multiple levels in the same patient. Biventricular obstruction occurs very rarely.

A systolic pressure gradient between the pumping chamber and its downstream artery is the primary hemodynamic abnormality of stenosis regardless of whether the obstruction is right- or left-sided. Turbulence occurring at the region of the stenosis creates an ejection quality murmur. The pressure gradient increases proportionally to the square of the flow rate through the obstructed area; therefore, the intensity of the murmur increases with heightened gradients. However, the severity of stenosis cannot be estimated accurately based solely on the pressure gradient because both the size of the orifice and the volume of flow through the narrowed area determine the pressure gradient....

You do not currently have access to this content.