[Evolution and prognosis of the adult Eisenmenger syndrome]

From the patients of the Cardiologic Department of the Medical Clinic of Leipzig University 34 adult patients aged 21 to 62 years with the diagnosis of Eisenmenger's syndrome confirmed by heart catheterization were established. The cases in question were 20 ventricular septum defects, 8 atrial septum defects and 6 open arterial ducts. In 26 of the 34 patients first symptoms appeared already during the preschool period, in 4 patients with atrial septum defect in the 12th year as well as between the 35th and 46th year of age, in 4 patients with ventricular septum defect twice in the 8th or 26th and 50th year of age, respectively. The average time of diagnostics from the beginning of the complaints to the heart catheterization was with 15 years and 3 months very long. The average survival time after diagnosis of shunt reversal by means of the heart catheter was 9.7 years in the ventricular septum defect, 5.6 years in the atrial septum defect and 3.8 years in the open arterial ducts. Since 19 of the 34 patients with Eisenmenger's syndrome are still alive and the moment of the shunt reversal does not correspond to the moment of the diagnostics, the average life expectancy is greater. It is higher than the values given in literature, which vary between 2 and 10 years after the beginning of the shunt reversal. The progressing of the clinical picture could be objectified by annual increases of various parameters, such as hemoglobin, hematocrit, angle alpha QRS, Sokolov's index for right hypertrophy and radiologically established sizes of surface and diameter of the heart and the pulmonary vessels. Correlations of abrupt enlargements and acute diseases were found only for the prominence of the pulmonary segment and the basal diameter of the heart. The examinations showed that in the course of Eisenmenger's syndrome the pulmonary hypertension, the polyglobulia, the right heart hypertrophy, the size of the heart and last not least the complaints increase continuously or in dependence of complications (heart insufficiency, carditis, pneumonia, embolism a.o.).