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Eisenmenger syndrome or Eisenmenger's syndrome is defined as the process in which a long-standing left-to-right cardiac shunt caused by a congenital heart defect (typically by a ventricular septal defect, atrial septal defect, or less commonly, patent ductus arteriosus) causes pulmonary hypertension [1] [2] and eventual reversal of the shunt into a cyanotic right-to-left shunt.
Although the mechanism is still unclear, it is thought to be caused by right to left shunting of blood flow due to an anatomic defect allowing communication between right and left-sided circulation, such as an atrial septal defect, patent foramen ovale, or pulmonary atrioventricular malformations, and a functional component that causes blood to ...
An uncorrected left-to-right shunt can progress to a right-to-left shunt; this process is termed Eisenmenger syndrome. [3] This is seen in Ventricular septal defect, Atrial septal defect, and patent ductus arteriosus, and can manifest as late as adult life. This switch in blood flow direction is precipitated by pulmonary hypertension due to ...
Atrial septal defect with left-to-right shunt. The left and right sides of the heart are named from a dorsal view, i.e., looking at the heart from the back or from the perspective of the person whose heart it is. There are four chambers in a heart: an atrium (upper) and a ventricle (lower) on both the left and right sides. [1]
It is caused by structural defects of the heart such as right-to-left or bidirectional shunting, malposition of the great arteries, or any condition which increases pulmonary vascular resistance. The result may be the development of collateral circulation.
The right-to-left shunt is an abnormal blood circulation that enables deoxygenated blood to pass from the right side to the left side of the heart and skips the lungs. Thus, no oxygenation occurs, and reduced gas exchange results in hypoxemia as fresh oxygen cannot reach the shunted blood. [ 18 ]
A ventricular septal defect arises when the superior part of the interventricular septum, which separates the right and left ventricles of the heart, fails to fully develop. The right ventricle pumps blood to the lungs to get oxygen, while the left ventricle pumps blood to the rest of the body to provide oxygen to tissues.
Additionally, if a paradoxical embolism is suspected in a patient, findings consistent with a congenital heart defect that may lead to right-to-left shunting can be evaluated. These include digital clubbing due to chronic hypoxemia in distal extremities or a widely-split S2, a pathological heartbeat pattern where the second heart sound has two ...