The Broken Heart with an Austrian Name
Format
Poster
Start Date
6-11-2020 12:30 PM
End Date
6-11-2020 12:45 PM
Abstract
Joel Brooks Tamayo Joel, MD, Internal Medicine, Kendall Regional Medical Center. Luis Caraballo, MD, Internal Medicine, Kendall Regional Medical Center. Daniel Gonzalez, MD, Internal Medicine, Kendall Regional Medical Center. Andres Sobrado, MD, Internal Medicine, Kendall Regional Medical Center. Jose Barros, MD, faculty. Jose Gascon, MD, Program Director Introduction Eisenmenger syndrome (ES) develops because of a significant left to right shunt causing the pulmonary artery approach systemic levels and the flow become bidirectional Case presentation This is a 66-year-old female with a past medical history of uncorrected ventricular septal defect (VSD) who presents complaining of severe shortness of breath associated with bluish discoloration of skin and bilateral leg swelling. Reports absence of chest pain, palpitations. P/E: Central cyanosis and clubbing. Increased intensity of S2. A mid-systolic ejection click and diastolic murmur on the second left intercostal space. EKG: NSR. RAD. RVH. No ST/T changes Echocardiogram: Enlargement of the main pulmonary artery Severe RVH. IVS flattening. Large trabecular VSD. Severe pulmonary hypertension. Bidirectional shunt. Discussion The mean age at death of patients with ES has been reported to be 37 years or less, although the individual clinical course is variable. Most patients die from decompensated heart failure, sudden cardiac death, or from intrapulmonary hemorrhage. Bosentan could be safely given to patient with ES and has improved outcomes. Annual flu shots and pneumococcal vaccines are also recommended. When patients are severe incapacitated the main intervention are lung transplantation with repair of the cardiac defect or heart lung-transplantation. Conclusion This case report presents the clinical features and the typical echocardiographic findings of ES. With the advent of surgical correction and interventional structural procedures of congenital heart disease, the prevalence of ES has declined in the developed world; nonetheless, a congenital heart disease specialist should follow all patients. Key words: Eisenmenger, pulmonary, hypertension, congenital
The Broken Heart with an Austrian Name
Joel Brooks Tamayo Joel, MD, Internal Medicine, Kendall Regional Medical Center. Luis Caraballo, MD, Internal Medicine, Kendall Regional Medical Center. Daniel Gonzalez, MD, Internal Medicine, Kendall Regional Medical Center. Andres Sobrado, MD, Internal Medicine, Kendall Regional Medical Center. Jose Barros, MD, faculty. Jose Gascon, MD, Program Director Introduction Eisenmenger syndrome (ES) develops because of a significant left to right shunt causing the pulmonary artery approach systemic levels and the flow become bidirectional Case presentation This is a 66-year-old female with a past medical history of uncorrected ventricular septal defect (VSD) who presents complaining of severe shortness of breath associated with bluish discoloration of skin and bilateral leg swelling. Reports absence of chest pain, palpitations. P/E: Central cyanosis and clubbing. Increased intensity of S2. A mid-systolic ejection click and diastolic murmur on the second left intercostal space. EKG: NSR. RAD. RVH. No ST/T changes Echocardiogram: Enlargement of the main pulmonary artery Severe RVH. IVS flattening. Large trabecular VSD. Severe pulmonary hypertension. Bidirectional shunt. Discussion The mean age at death of patients with ES has been reported to be 37 years or less, although the individual clinical course is variable. Most patients die from decompensated heart failure, sudden cardiac death, or from intrapulmonary hemorrhage. Bosentan could be safely given to patient with ES and has improved outcomes. Annual flu shots and pneumococcal vaccines are also recommended. When patients are severe incapacitated the main intervention are lung transplantation with repair of the cardiac defect or heart lung-transplantation. Conclusion This case report presents the clinical features and the typical echocardiographic findings of ES. With the advent of surgical correction and interventional structural procedures of congenital heart disease, the prevalence of ES has declined in the developed world; nonetheless, a congenital heart disease specialist should follow all patients. Key words: Eisenmenger, pulmonary, hypertension, congenital