Eisenmenger Syndrome After Delayed Atrial Septal Defect Closure at High Altitude: A Case Report.
Angelica Guaman-Gavilema, Domenica Villacres-Alarcon, Andres Arteaga-Arellano et al.
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Case in brief
A 46-year-old woman presented with severe cyanosis and heart failure 22 years after atrial septal defect closure, living at high altitude in the Ecuadorian Andes. She exhibited marked hypoxemia and secondary erythrocytosis. Diagnostic imaging revealed severe pulmonary artery pressure and right-chamber dilation. Management included pulmonary vasodilators and supportive care, leading to symptomatic stabilization and discharge after four days.
What made this case unusual
The case highlights the development of Eisenmenger syndrome two decades post-surgery, exacerbated by chronic high-altitude hypoxia, which is uncommon in high-income regions.
Diagnostic / clinical pearl
Clinicians should consider the risk of Eisenmenger syndrome in patients with a history of atrial septal defect repair, especially in high-altitude environments.
Why it matters
This case underscores the importance of early detection and management of congenital heart defects in resource-limited settings to prevent severe complications like Eisenmenger syndrome.