Consider the following statements regarding Eisenmenger Syndrome: 1. In patients with severe and prolonged pulmonary hypertension, the right-to-left shunt gets reversed to a left-to-right shunt. 2. There is marked cyanosis, which may be more apparent in the feet and toes than in the upper part of the body. 3. Antihypertensives which cause peripheral vasodilatation can exacerbate the shunting and worsen the symptoms. Which of the statements given above is/are correct?
2 and 3
In Eisenmenger syndrome, the original left-to-right shunt reverses to a right-to-left shunt due to prolonged pulmonary hypertension, so statement 1 is worded incorrectly (reversed direction). Differential cyanosis with more pronounced cyanosis/clubbing in the lower extremities (feet/toes) is a classic feature when the shunt is at the ductal level (statement 2 correct). Peripheral vasodilators reduce systemic vascular resistance, which increases right-to-left shunting and worsens cyanosis (statement 3 correct). Hence 2 and 3 are correct.
Important Questions from Ischemic Heart Disease
- A 60-year-old diabetic female presents with acute myocardial infarction. ECG changes include ST elevation greater than 1 mm in lead aVR. The likely localization of thrombosis is in
- An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for follow-up, with complaints of muscle pains. Which one of the following drugs could be the most likely cause?
- All of the following are indications for treadmill testing/exercise-testing EXCEPT:
A 60-year-old man comes to emergency with history of chest pain, which is acute onset. The ECG shows ST depression and T waves inversion. Cardiac biomarkers in blood are not elevated. What will be the appropriate management?
- Which one of the following is not a differential diagnosis of ST segment elevation in ECG?
