Unusual clinical and echocardiographic features of severe isolated pulmonic insufficiency.

A 57-year-old psoriatic man had severe, isolated pulmonic regurgitation, with intractable right sided failure. Echocardiography showed flail pulmonic leaflet and premature opening of the valve. Cardiac catheterization documented severe pulmonic regurgitation. The right ventricular end-diastolic pressure was elevated above the pulmonary artery diastolic pressure, thus explaining the echocardiographic finding. The patient was treated successfully by pulmonic valve replacement.