What is Eisenmenger syndrome?
Eisenmenger syndrome (or ES, Eisenmenger’s reaction or tardive cyanosis) is defined as the process in which a left to right shunt caused by a congenital heart defect in the fetal heart which leads to an increase in the flow to the pulmonary vasculature, causes pulmonary hypertension, which in turn causes increased pressures in the right side of the heart and reversal of the shunt into a right-to-left shunt.
Who is more prone to get affected by Eisenmenger syndrome?
The development of this syndrome occurs in puberty but may develop in adolescence and early adulthood.
What are the causes of Eisenmenger syndrome?
There are multiple causes for Eisenmenger syndrome
Congenital heart defects leading to this syndrome are as follows:
• Atrial septal defects
• Ventricular septal defects
• Patent ductus arteriosus
• Acyanotic heart disease
What are the indicated signs and symptoms of Eisenmenger syndrome?
Symptoms of Eisenmenger Syndrome include-
• Fainting
• Feeling tired
• Shortness of breath
• Stroke
• Swelling in the joints caused by too much uric acid
• Chest pain
• Coughing up blood
• Bluish lips, fingers, toes, and skin
• Dizziness
Clinically the patient show the following symptoms –
• Cyanosis
• High red blood cell count
• Swollen or clubbed fingertips
• Fainting called syncope
• Heart failure
• Arrhythmia or irregular heart rhythms
• Bleeding disorders
• Coughing up blood
• Iron deficiency
• Kidney problems
• Gout
• Gallstones
What are the investigations advised in Eisenmenger syndrome?
Laboratory investigations to be done are as follows-
• Complete blood count
• Increased conjugated bilirubin
• Increased uric acid
• Urea and creatinine are sometimes elevated
• Urinary biochemical analysis reveals proteinuria
Other findings to be done are as follows-
• Pulse oximetry
• Arterial blood gas
• Brain natriuretic peptide
Imaging studies to be done are as follows-
• Chest radiography
• Magnetic resonance imaging
• Echocardiography
• Electrocardiography
• Cardiac catheterization
What is the treatment of Eisenmenger syndrome?
Medications include are as follows-
• Diuretics
• Cardiac glycosides
• Prostaglandins
• Iron products
• Endothelin antagonists
• Phosphodiesterase-5 enzyme inhibitors
Treatment procedures include-
• Oxygen therapy
• Pulmonary vasodilation therapy
• Transplantation is done such as
-Heart-lung transplantation
-Bilateral lung transplantation
What are the complications of Eisenmenger syndrome?
Possible complications are as follows: –
• Gout
• Heart attack
• Hyperviscosity
• Infection in the brain
• Kidney failure
• Poor blood flow to the brain
• Stroke
• Sudden death
• Bleeding in the brain
• Congestive heart failure
What is the prognosis of Eisenmenger syndrome?
How well the infant or child depends on another medical condition and the age at which high blood pressure develops in the lungs. Patients who develop this syndrome can live 20 to 50 years.
What is the differential diagnosis of Eisenmenger syndrome?
• Primary, Pulmonary hypertension
• Tetralogy of Fallot
• Idiopathic pulmonary hypertension
• Persistent newborn pulmonary hypertension
• Pulmonary infarction
• Respiratory failure
• Tetralogy of Fallot with absent pulmonary valve
• Tetralogy of Fallot with pulmonary atresia
• Total anomalous pulmonary venous connection
• Transposition of the great arteries
• Tricuspid atresia
• Truncus arteriosus
• Ventricular septal defect (VSD)
• Pulmonary atresia with VSD
• Single ventricle with pulmonary stenosis
What are the Homeopathic remedies for symptomatic management of Eisenmenger syndrome?
-Cactus G
-Digitalis
-Kali-Bi
-Stannum Met
-Arsenic Alb
