Eisenmenger’s syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]

Overview

Eisenmenger's syndrome should be differentiated from idiopathic pulmonary hypertension, pulmonary infarction, respiratory failure, tricuspid atresia, persistent truncus arteriosus, and other congenital heart diseases.

Differential Diagnosis of causes of Eisenmenger's Syndrome

Eisenmenger's syndrome should be differentiated from idiopathic pulmonary hypertension, pulmonary infarction, respiratory failure, tricuspid atresia, persistent truncus arteriosus, and other congenital heart diseases[1][2][3][4].

Disorders Etiology Clinical Presentation Laboratory Findings Electrocardiogram Echocardiography
Idiopathic Pulmonary Hypertension Unknown, but possible reasons may include
  • +ve ANA assay
  • +ve ANCA
  • Anti-topoisomerase antibody
  • Thyrotropin: screen thyroid disorders
  • Elevated BNP & N-terminal BNP.
Respiratory Failure Electrocardiography may be used to evaluate the underlying cardiac causes of respiratory failure. Echocardiography may be used to evaluate the underlying cardiac causes of respiratory failure.
Pulmonary Infarction
The main diagnostic studies are
Tetralogy of Fallot Multifactorial Echocardiography may show:
  • Residual VSD or ASD
  • RV outflow tract obstruction
  • Abnormal valvular anatomy
Total Anomalous Pulmonary Venous Connection

Multifactorial

Tricuspid Atresia Multifactorial
  • Respiratory difficulties as nasal flaring or muscle retractions
  • Cyanosis
  • Growth retradation
  • Tall P waves indicate atrial enlargement.
  • Frontal plane QRS axis may be leftward.
Echocardiography may show
Ventricular Septal Defect Multifactorial

Echocardiography may show

Transposition of the Great Arteries Multifactorial Echocardiography may show:
Persistent truncus arteriosus Echocardiography may show

References

  1. "StatPearls". 2020. PMID 29939577.
  2. Moons P, Canobbio MM, Budts W (2009). "Eisenmenger syndrome: A clinical review". Eur J Cardiovasc Nurs. 8 (4): 237–45. doi:10.1016/j.ejcnurse.2009.05.004. PMID 19541542.
  3. Vongpatanasin W, Brickner ME, Hillis LD, Lange RA (1998). "The Eisenmenger syndrome in adults". Ann Intern Med. 128 (9): 745–55. doi:10.7326/0003-4819-128-9-199805010-00008. PMID 9556469.
  4. Berman EB, Barst RJ (2002). "Eisenmenger's syndrome: current management". Prog Cardiovasc Dis. 45 (2): 129–38. doi:10.1053/pcad.2002.127492. PMID 12411974.




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