Eisenmenger syndrome - True are A/E aEUR'
RV & LV walls come back to normal size aiitns pgmee answers & explanations - May 2010 In Eisenmenger's syndrome pulmonary vascular resistance increases because of increased shear stress on pulmonary aerioles. Pulmonary hypeension in Eisenmenger Syndrome Early in disease Result of markedly increased blood flow (hyperkinetic pulmonary hypeension) Reversible (decreases with the administration of pulmonary vasodilators or oxygen or both) Later in the disease Seen with the development of hypeension Result of pulmonary vascular disease Minimally responsive (to pulmonary vasodialtors or oxygen or not at all). These changes are graded on the basis of histological characteristic: - Grade I Grade II Grade III -4 Grade IV Grade V and VI Medial hyperophy alone Medial hyperophy and hyperplasia Near obliteration of vessel lumen Aerial dilatation Plexiform lesions, angiomatoid formation fibrinoid necrosis The characterist pathological pulmonary vascular changes that develop in a patients with Eisenmengher's syndrome are confined to aeries only and involve small pulmonary aerioles and muscular ateries.(Veins are not involved) Radiographically Eisenmenger syndrome demonstrates: ? The hea varies in size .from normal to greatly enlargeddeg. The main pulmonary aeries are generally prominentQ. The pulmonary vessels are enlarged in hilar areas and taper rapidly in caliber in the peripheral branches0. Prominent right ventricle and atriumdeg. Marked right ventricular hyperophy in ECG.deg Thick walled right ventricle on echocardiogram
Pulmonary veins are not distended
RV & LV walls come back to normal size
Dilatation of central pulmonary aery
Peripheral pruning of pulmonary aeries