DR Medhat MRCP

Eisenmenger's syndrome
- In acyanotic congenital heart disease , there is left to right shunt ASD,VSD,PDA).
- With time, the patient will develop reversal of left to right shunt due to pulm. HTN.
- The original murmer may disappear once
Eisenmenger syndrome develops.
Features ( the key point is pulmonary HTN)
Management
سؤال 1. Original murmur may disappear
2. Cyanosis
3. Clubbing
4. Right ventricular failure, ↑ JVP, ↑ a- wave
, ↑S2
5. Haemoptysis, embolism
Heart-lung transplantation .
Patent ductus arteriosus
• Overview
Acyanotic congenital heart defect
Connection between the pulmonary trunk and descending aorta
More common in premature babies, born at high altitude or maternal rubella
infection in the first trimester
• Features :
Left subclavicular thrill
Continuous 'machinery' murmur best heared over left infraclavicular area.
Large volume, bounding, collapsing pulse
Wide pulse pressure
Heaving apex beat
• Management
Indomethacin closes the connection in the majority of cases.
Prostaglandin E1 if associated with another congenital heart defect amenable to
surgery then it is useful to keep the duct open until after surgical repai
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