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In pulmonary stenosis the pulmonary valve may be deformed, thickened and narrowed. There is hypertrophy of the right ventricle as it tries to overcome the obstruction. The hypertrophy of of the right ventricle, and the infundibulum serve to increase the degree of obstruction.
Pulmonary stenosis is generally valvular with fusion of the pulmonary valve commissures.
Supravalvular pulmonary stenosis is due to narrowing of the main pulmonary trunk, pulmonary arterial bifurcation, or pulmonary branches.