Incidentally diagnosed severe pulmonary valvar stenosis complicated by secondary cardiac hepatopathy in an adolescent: balloon valvoplasty as a bridge to surgery.

Severe pulmonary valvar stenosis may remain silent into adolescence. A 17-year-old girl attended with vaginal bleeding; the diagnosis rested on a grade 6/6 murmur found on examination. Aminotransferases rose despite correction of anaemia and hypotension and fell only after balloon valvoplasty relieved the obstruction. The valve being dysplastic, valvoplasty was not curative, but it reversed the hepatic injury and allowed valve replacement to proceed safely.