Eisenmenger Syndrome

Question 1

What is Eisenmenger syndrome

Answer 1

Occurs when the blood flows from the right side of the heart to the left across a structural heart lesion bypassing lungs

Question 2

Causes of Eisenmenger syndrome

Answer 2

Atrial septal defect, ventricular septal defect, patent ductus arteriosus

Question 3

Findings in Eisenmenger syndrome which are related to pulmonary hypertension

Answer 3

Right ventricular heave, loud P2, raised JVP, peripheral oedema

Question 4

Findings in eisenmenger syndrome related to the right to left shunt and chronic hypoxia

Answer 4

Cyanosis, clubbing, dysopnoea, plethoric complexion

Question 5

How does Eisenmenger occur

Answer 5

ASD or VSD allows left to right shunt due to pressure in left side of the heart. Caues pulmonary HTN and when pulmonary pressure is greater than systemic pressure, there is a subsequent right to left shunt. This means now blood is bypassing lungs causing cyanosis

Question 6

Prognosis of Eisenmenger syndrome

Answer 6

Reduced life expectancy by about 20 years. Main causes of death are HF, thromboembolism, infection, and haemorrhage - mortality of 50% in pregnancy

Question 7

Management of Eisenmenger syndrome

Answer 7

Underlying defect managed, only definitive treatment once progressed is heart lung transplant.

Question 8

Prevention of Eisenmenger syndrome

Answer 8

Treating hypertension, anticoagulation, prophylactic Abx