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Eisenmenger syndrome — SCE Respiratory MCQ

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HardPulmonary Vascular DiseaseEisenmenger syndromeSCE Respiratory

A 36-year-old woman with repaired congenital heart disease develops exertional cyanosis and haemoptysis. Oxygen saturation is 86% on air; echo shows severe pulmonary hypertension with right-to-left shunting across a residual ventricular septal defect. What is the most likely diagnosis?

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Correct answer: D — Eisenmenger syndrome

Severe pulmonary hypertension with reversal of congenital shunt flow causing cyanosis is Eisenmenger syndrome. Asthma, hepatopulmonary syndrome and pulmonary veno-occlusive disease do not explain the residual VSD with right-to-left shunting. CTEPH can cause PH but would not typically produce congenital shunt reversal as described.

Reference: ESC/ERS Pulmonary Hypertension Guideline 2022