bubble_chart Overview

Eisenmenger syndrome can be classified into narrow and broad definitions. The former refers to ventricular septal defect, overriding aorta, and right ventricular hypertrophy. The latter encompasses any condition where there is communication between the left and right heart chambers or major vessel shunts accompanied by pulmonary hypertension, resulting in right-to-left shunting and persistent cyanosis. Therefore, conditions such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus complicated by pulmonary hypertension leading to right-to-left shunting are all referred to as Eisenmenger syndrome.

bubble_chart Diagnosis

(1) Symptoms In addition to the symptoms of the original left-to-right shunt disease, persistent cyanosis often begins during school age and progressively worsens.

(2) Signs Cyanosis and clubbing of fingers and toes. The cardiac border is enlarged, and a grade II-III systolic murmur is heard at the left sternal border in the 2nd and 3rd intercostal spaces (pulmonary valve area). The original defect murmur is reduced or disappears. P2 is hyperactive without significant splitting. (2) X-ray examination The right ventricle is significantly enlarged. The pulmonary segment is markedly split.

(3) Electrocardiogram Right atrial hypertrophy and right ventricular hypertrophy. The original left ventricular hypertrophy disappears and is replaced by right ventricular hypertrophy.

(4) Echocardiography The original defect can be detected. Color Doppler can show the right-to-left shunt at the defect site.

(5) Cardiac catheterization and angiography

1. The oxygen saturation of stirred pulse blood decreases; a significant right-to-left shunt appears.
2. Pulmonary stirred pulse hypertension, close to systemic circulation pressure; pulmonary vascular resistance increases.
3. Selective heart blood vessel angiography helps determine the defect location.

(6) Natural course and prognosis The prognosis of this syndrome is poor, with progressive worsening of cyanosis, but it can persist for many years until heart failure develops. Common complications and causes of death include sudden hemoptysis (pulmonary stirred pulse thrombosis or rupture of small pulmonary stirred pulse aneurysms), pulmonary infections, infective endocarditis, and heart failure.

bubble_chart Treatment Measures

The opportunity for surgical treatment has been lost. Medical treatment can only address complications, and there is no ideal method to reduce pulmonary vascular resistance.