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Wednesday, February 23, 2011

EISENMENGER'S SYNDROME

This is pulmonary hypertension complicating an initial left-to-right shunt. Progressive changes take place in the pulmonary vessels, and once established the increased resistance is irreversible.
It is more common with large ventricular septal defects or persistent ductus arteriosus than with atrial septal defect.
The murmur disappears, and the cardiac action is less forceful. Central cyanosis appears, and finger clubbing develops. The chest radiograph shows a small heart shadow, enlarged central pulmonary arteries and peripheral 'pruning' of the pulmonary vessels.  The ECG shows right ventricular hypertrophy.

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