congenital - by far the most common. Thick deformed bicuspid or tricuspid valves, sometimes associated with Noonan's syndrome, William's syndrome, or Fallot's tetralogy. Peripheral and valvular pulmonary stenosis may occur in rubella syndrome
rheumatic involvement of the pulmonary valve - rare
carcinoid tumours of the small bowel with hepatic metastases - these are associated with acquired thickening of valves on the right side of the heart
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