Eisenmenger Syndrome Flashcards
When does Eisenmenger syndrome occur?
When blood flows from the right side of the heart to the left across a structural heart lesion, bypassing the lungs.
What is Eisenmenger syndrome?
The reversal of a left-to-right shunt in a congenital heart defect due to pulmonary hypertension.
What 3 underlying lesions can result in Eisenmenger syndrome?
- Atrial septal defect
- Ventricular septal defect
- Patent ductus arteriosus
What does Eisenmenger syndrome eventually cause?
Obstruction to pulmonary blood and pulmonary hypertension.
What are the features of Eisenmenger syndrome?
- original murmur may disappear
- cyanosis
- clubbing
- right ventricular failure
- haemoptysis, embolism
What examinations findings would there be for Eisenmenger Syndrome due to the pulmonary hypertension?
- Right ventricular heave
- Loud P2
- Raised JVP
- Peripheral oedema
What causes the right ventricular heave?
The right ventricle contracts forcefully against increased pressure in the lungs
What causes the loud P2?
Loud second heart sound due to forceful shutting of the pulmonary valve
What examinations findings would there be for Eisenmenger Syndrome related to the underlying septal defect?
- Atrial septal defect:
- Ventricular septal defect: pan-systolic murmur loudest at the left lower sternal border
- Patent ductus arteriosus: continuous crescendo-decrescendo “machinery” murmur
- Arrhythmias
How is the murmur that atrial septal defect presents with described?
Mid-systolic, crescendo-decrescendo murmur- loudest at the upper left sternal border
How is the murmur that ventricular septal defect presents with described?
Pan-systolic murmur loudest at the left lower sternal border
How is the murmur that patent ductus arteriosus presents with described?
Continuous crescendo-decrescendo “machinery” murmur
What examinations findings would there be for Eisenmenger Syndrome related to the right to left shunt and chronic hyperplasia?
- Cyanosis
- Clubbing
- Dyspnoea
- Plethoric complexion (a red complexion related to polycythaemia)
What effect does Eisenmenger’s syndrome have on life expectancy?
It reduces life expectancy by around 20 years compared with healthy individuals.
What are the main causes of death in Eisenmenger’s syndrome?
- Heart failure
- Infection
- Thromboembolism
- Haemorrhage.
