Eisenmenger’s syndrome overview: Difference between revisions
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== Causes == | == Causes == | ||
[[Eisenmenger's syndrome]] is causes by cardiac defects that shunt blood heading to the systemic circulation back into the pulmonary circulation. These defects include [[ventricular septal defect]], [[atrial septal defect]], [[Atrioventricular canal defect (patient information)|atrioventricular canal defect]], [[patent ductus arteriosus]], and [[truncus arteriosus]]. | |||
== Differentiating | == Differentiating Eisenmenger's syndrome from Other Diseases == | ||
== Epidemiology and Demographics == | == Epidemiology and Demographics == | ||
The [[incidence]] and [[prevalence]] of [[Eisenmenger's syndrome]] has been decreasing gradually over the years. In the general population, the prevalence decreased from 24.6 to 11.9/million inhabitants in 2012. About 8% of patents with [[Congenital heart disease|congenital heart diseases]] develop Eisenmenger's syndrome. The [[mortality rate]] of Eisenmenger's syndrome is about 27%. The risk of [[Eisenmenger's syndrome]] increases in patients with large cardiac defects or who live in developing countries due to poor healthcare access. | |||
== Risk Factors == | == Risk Factors == | ||
The common risk factors for [[Eisenmenger's syndrome]] include genetic [[Mutation|mutations]], exposure to [[rubella]] virus, and drug and [[alcohol]] abuse during pregnancy. Less common risk factors include poor healthcare access and patients in developing countries. | |||
== Screening == | == Screening == | ||
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=== Laboratory Findings === | === Laboratory Findings === | ||
The laboratory findings of patients with Eisenmenger's syndrome include [[erythrocytosis]], [[Iron deficiency anemia|iron deficiency]], increased [[bleeding time]], increased blood [[uric acid]] and [[conjugated bilirubin]] concentrations, as well as mixed [[Respiratory acidosis|respiratory]] and [[metabolic acidosis]]. | |||
=== Electrocardiogram === | === Electrocardiogram === | ||
=== X-ray === | === X-ray === | ||
Chest [[X-rays|X-ray]] of patients with [[Eisenmenger's syndrome]] may show [[cardiomegaly]], right ventricular or biventricular enlargement, right atrial or biatrial enlargement, and pulmonary vascular [[plethora]]. | |||
=== Echocardiography and Ultrasound === | === Echocardiography and Ultrasound === | ||
=== CT scan === | === CT scan === | ||
[[Computed tomography]] can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive. The findings on CT scan may include large main [[pulmonary artery]], [[ventricular septal defect]], and [[right ventricular hypertrophy]]. | |||
=== MRI === | === MRI === | ||
[[Magnetic resonance imaging]] can be helpful as a diagnostic tool in conditions where the [[echocardiographic]] findings are inconclusive. The following can be observed on MRI examination of [[Eisenmenger's syndrome]] patients: Magnitude and direction of the [[cardiac shunt]], reduced systolic function of the cardiac [[Ventricle|ventricles]], and brain [[diffusion]] changes on brain [[Magnetic resonance imaging|MRI]]. | |||
=== Other Imaging Findings === | === Other Imaging Findings === | ||
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=== Medical Therapy === | === Medical Therapy === | ||
=== Surgery === | === Surgery === | ||
Revision as of 05:01, 20 January 2020
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Eisenmenger’s syndrome Microchapters |
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Diagnosis |
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Eisenmenger’s syndrome ACC/AHA Guidelines for Evaluation of Patients |
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Treatment |
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Eisenmenger’s syndrome overview On the Web |
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American Roentgen Ray Society Images of Eisenmenger’s syndrome overview |
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Risk calculators and risk factors for Eisenmenger’s syndrome overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2], Priyamavada Singh, MBBS [3];Kristin Feeney, B.S. [4]
Overview
Eisenmenger's syndrome or Eisenmenger's reaction is defined as the process in which a left-to-right shunt in the heart causes increased flow through the pulmonary vasculature, which leads to pulmonary hypertension, which finally causes increased pressures in the right side of the heart and reversal of the shunt into a right-to-left shunt. This right to left shunt causes the patient to become cyanotic. Thus, Eisenmenger's syndrome is said to develop when there is a pulmonary artery disease, right-to-left heart shunting and cyanosis.
Historical Perspective
Victor Eisenmenger first described the syndrome in 1897 in a patient who presented with dyspnea and cyanosis since infancy. Since then, advances in the medical treatment of pulmonary hypertension improved the survival of Eisenmenger's syndrome.
Classification
Pathophysiology
Causes
Eisenmenger's syndrome is causes by cardiac defects that shunt blood heading to the systemic circulation back into the pulmonary circulation. These defects include ventricular septal defect, atrial septal defect, atrioventricular canal defect, patent ductus arteriosus, and truncus arteriosus.
Differentiating Eisenmenger's syndrome from Other Diseases
Epidemiology and Demographics
The incidence and prevalence of Eisenmenger's syndrome has been decreasing gradually over the years. In the general population, the prevalence decreased from 24.6 to 11.9/million inhabitants in 2012. About 8% of patents with congenital heart diseases develop Eisenmenger's syndrome. The mortality rate of Eisenmenger's syndrome is about 27%. The risk of Eisenmenger's syndrome increases in patients with large cardiac defects or who live in developing countries due to poor healthcare access.
Risk Factors
The common risk factors for Eisenmenger's syndrome include genetic mutations, exposure to rubella virus, and drug and alcohol abuse during pregnancy. Less common risk factors include poor healthcare access and patients in developing countries.
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
The laboratory findings of patients with Eisenmenger's syndrome include erythrocytosis, iron deficiency, increased bleeding time, increased blood uric acid and conjugated bilirubin concentrations, as well as mixed respiratory and metabolic acidosis.
Electrocardiogram
X-ray
Chest X-ray of patients with Eisenmenger's syndrome may show cardiomegaly, right ventricular or biventricular enlargement, right atrial or biatrial enlargement, and pulmonary vascular plethora.
Echocardiography and Ultrasound
CT scan
Computed tomography can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive. The findings on CT scan may include large main pulmonary artery, ventricular septal defect, and right ventricular hypertrophy.
MRI
Magnetic resonance imaging can be helpful as a diagnostic tool in conditions where the echocardiographic findings are inconclusive. The following can be observed on MRI examination of Eisenmenger's syndrome patients: Magnitude and direction of the cardiac shunt, reduced systolic function of the cardiac ventricles, and brain diffusion changes on brain MRI.