Rheumatic pulmonary valve disease
Organic rheumatic pulmonary valve disease is extremely rare. It has been reported along with disease of the other valves, like a case of quadrivalve disease. Pulmonary valve involvement this case was less severe than that of aortic valve involvement. There was pulmonary stenosis and regurgitation. Some other cases of quadrivalve involvement in clinical and autopsy series are also there.
A much more common situation is hypertensive pulmonary regurgitation in mitral valve disease with severe pulmonary hypertension. This is associated with loud pulmonary component of second heart sound (P2) which may also be palpable and a blowing early diastolic murmur in the pulmonary area (Graham Steell murmur).