Simple pulmonary stenosis; pulmonary valvular stenosis with a closed ventricular septum.

Jimmy appeared to be a normal child and when he was three and had bronchitis his parents were shocked to be told that he had congenital heart disease. He was, however, able to do everything like other boys and seemed so healthy that they thought less and less of this, until when he was about 12 he became more breathless on playing games: he had gradually developed highcoloured cheeks and his face and hands went blue in cold weather more easily than other children. When he was 18 he began to find life difficult for the first time: he could not cycle or run so well and became blue with exertion as well as with cold. Within a few months he could not walk so far and could no longer manage his work. This is a characteristic story of a child with simple pulmonary stenosis which is defined as congenital pulmonary valvular stenosis with a closed ventricular septum. The picture is, however, very varied for some patients remain well and acyanotic for much longer, and others become cyanotic and disabled earlier.