Volume 4, Number 13; July 21, 2005
|
Volume 4, Number 13; July 21, 2005 |
|
|
|
|
|
|
|
|
32 year old Hispanic female having syncopal episodes.
Recommended reading:
|
Patient:
|
|
Session Handout:
|
|
Clinical Question: What is Eisenmenger's syndrome? |
|
Readings:
<2> Link Directly to Fulltext article in Ovid Unique Identifier [PMID]: 11895573 Authors: Alvarez N. Prieur T. Connelly M. Institution: Division of Cardiology and Calgary Adult Congenital Heart Disease Clinic of Peter Lougheed Centre, University of Calgary, Alberta, Canada. Title: The ten most commonly asked questions about management of congenital heart disease in adults. [Review] [3 refs]
Source: Cardiology in Review. 10(2):77-81, 2002 Mar-Apr. Publication Type: Journal Article. Review. Review, Tutorial.
<7> Link Directly to Fulltext article in Ovid Unique Identifier [PMID]: 9556469 Authors: Vongpatanasin W. Brickner ME. Hillis LD. Lange RA. Institution: University of Texas Southwestern Medical Center, Dallas, USA. Title: The Eisenmenger syndrome in adults. [Review] [91 refs]
Source: Annals of Internal Medicine. 128(9):745-55, 1998 May 1. Abstract: For this article, the literature on the pathophysiology, clinical features, natural history, prognosis, and management of the Eisenmenger syndrome in adults was reviewed. English-language articles from 1966 to the present were identified through a search of the MEDLINE database by using the terms Eisenmenger, congenital heart disease, and pulmonary hypertension. Selected cross-referenced articles were also included. Articles on the pathophysiology, clinical presentation, evaluation, natural history, complications, and treatment of the Eisenmenger syndrome in adults were selected, and descriptive and analytical data relevant to the practicing physician were manually extracted. The Eisenmenger syndrome is characterized by elevated pulmonary vascular resistance and right-to-left shunting of blood through a systemic-to-pulmonary circulation connection. Most patients with the syndrome survive for 20 to 30 years. The hemostatic changes associated with the syndrome may lead to thromboembolic events, cerebrovascular complications, or the hyperviscosity syndrome. Erythrocytosis is present in most patients, but excessive phlebotomy may cause microcytosis and exacerbate the symptoms of hyperviscosity. Other complications associated with the Eisenmenger syndrome include hemoptysis, gout, cholelithiasis, hypertrophic osteoarthropathy, and decreased renal function. Pregnancy or noncardiac surgery is associated with a high mortality rate in patients with the Eisenmenger syndrome. Because most pediatric patients with the Eisenmenger syndrome survive to adulthood, primary care physicians should have a thorough understanding of the syndrome; its associated complications; and medical and surgical management, especially with regard to the appropriate timing of phlebotomy and lung or heart-lung transplantation. In addition, patients with the syndrome should undergo routine follow-up at a tertiary care center that has physicians and nurses with special expertise in congenital heart disease. In patients with the Eisenmenger syndrome who are pregnant or require noncardiac surgery, a multidisciplinary approach should be used to reduce the excessive mortality associated with these conditions. [References: 91] Publication Type: Journal Article. Review.
|
|
|
|
|
Resident Report / Department of Medicine & Grady Branch Library Emory University School of Medicine 2005 Edition Participating Faculty: Carlos Del Rio MD / Joyce Doyle MD / Lorenzo Difrancesco MD / Erich Folch MD / Alicia Hidron MD
Contact:
Karl Woodworth
|
