title: Thoracic manifestation of Eisenmenger's syndrome in adult patients: a MDCT review.
abstract: Eisenmenger's syndrome (ES) is the most advanced form of pulmonary arterial hypertension (PAH) associated with congenital heart diseases (CHD). It is caused by simple or complex CHD with a large systemic-to-pulmonary shunt. When the pulmonary pressure exceeds the systemic pressure, the shunt reverses and central cyanosis appears. ES is a progressive and fatal condition, and it is accompanied by an increased risk of a range of potentially life-threatening complications. Patients with ES are both at risk for bleeding, due to damaged capillaries and high pressure, and for in situ pulmonary thrombosis, related to hyper-viscosity and slow blood flow in dilated pulmonary arteries. Moreover, the enlarged main pulmonary arteries and cardiac chambers may determine displacement or extrinsic compression on airways, pulmonary veins, coronary arteries, and other mediastinal structures. The clinical effects may be diverse, such as respiratory difficulties, localized pulmonary edema, cardiac dysfunction, or sudden death. Multidetector computed tomography (MDCT) allows to accurately assess in a single examination, pulmonary parenchyma and vessels, coronary artery origin, and heart chambers. The aim of this review was to illustrate the thoracic MDCT angiography findings and complications of adult patients with PAH-CHD and in particular of those with ES.
authors.affiliation: Cardio-Thoracic Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S. Orsola-Malpighi, via Massarenti 9, 40100, Bologna, Italy, dome.attina@gmail.com.
authors.forename: Domenico
authors.initials: D
authors.lastname: Attinà
authors.forename: Fabio
authors.initials: F
authors.lastname: Niro
authors.forename: Giorgio
authors.initials: G
authors.lastname: Garzillo
authors.forename: Cecilia
authors.initials: C
authors.lastname: Modolon
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
authors.forename: Luigi
authors.initials: L
authors.lastname: Lovato
authors.forename: Nazareno
authors.initials: N
authors.lastname: Galiè
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zompatori
mesh_terms: D000328:Adult; D001981:Bronchial Arteries / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004541:Eisenmenger Complex / Q000150:complications / Q000000981:diagnostic imaging*; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008168:Lung / Q000000981:diagnostic imaging; D061330:Multidetector Computed Tomography; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011667:Pulmonary Veins / Q000000981:diagnostic imaging