From the Guidelines
The pulmonary valve diameter z-score for a 5-year-old female with a body surface area (BSA) of 0.73 m² should typically fall between -2 and +2 to be considered within normal range. For this specific patient, the expected normal pulmonary valve diameter would be approximately 12-14 mm, with a z-score of 0 representing the population mean 1. Z-scores below -2 may indicate pulmonary valve stenosis or hypoplasia, while z-scores above +2 could suggest dilation of the pulmonary valve annulus. When evaluating this patient's pulmonary valve, it's essential to consider the z-score in context with clinical symptoms and other echocardiographic findings, as advised by the European Association of Cardiovascular Imaging of the European Society of Cardiology and the Association for European Paediatric and Congenital Cardiology 1. The z-score calculation accounts for the child's smaller body size, as BSA of 0.73 m² is appropriate for a 5-year-old female, allowing for proper scaling of cardiac structures relative to body size. If abnormal z-scores are found, further evaluation with additional imaging or cardiology consultation would be warranted to determine clinical significance and potential need for intervention.
Some key points to consider when evaluating the pulmonary valve diameter z-score include:
- The use of z-scores is advised for quantification in the pediatric age, as it allows for proper scaling of cardiac structures relative to body size 1
- A basic quantification of cardiac structures, including LV size and aortic diameters, is advised in older children and/or with the suspicion of congenital or acquired heart diseases 1
- Measurements should refer to specific age and body size reference values, as provided in Table 4 of the European Heart Journal 1
- In uncooperative children, sedation is advised when complete examination is required, such as pre-operative or clinical instability 1
From the Research
Pulmonary Valve Diameter Z-Scores
To determine the pulmonary valve diameter z-scores for a 5-year-old female with a body surface area (BSA) of 0.73, we need to consider the available evidence.
- The provided studies do not directly report pulmonary valve diameter z-scores for a 5-year-old female with a BSA of 0.73 2, 3, 4, 5, 6.
- Study 2 discusses the echocardiographic evaluation of pulmonary valve stenosis but does not provide z-scores for pulmonary valve diameter.
- Study 3 reports on the results of balloon valvuloplasty in typical and dysplastic pulmonary valve stenosis, including Doppler echocardiographic follow-up, but does not provide z-scores for pulmonary valve diameter.
- Study 4 focuses on the measurement of mitral valve orifice area in infants and children by two-dimensional echocardiography, which is not relevant to pulmonary valve diameter z-scores.
- Study 5 compares body surface area in normal-weight, overweight, and obese adults, which is not directly relevant to pulmonary valve diameter z-scores in children.
- Study 6 discusses normal values of left atrial volume in the pediatric age group using a validated allometric model, but does not provide information on pulmonary valve diameter z-scores.
Available Data
- There are no research papers provided that directly assist in answering the question about pulmonary valve diameter z-scores for a 5-year-old female with a BSA of 0.73.
- The studies provided do not offer the necessary data to calculate or estimate the z-scores for pulmonary valve diameter in this specific case 2, 3, 4, 5, 6.