CTICasesEisenmenger's Syndrome
Imaging findings
CT angiography shows a large, unrepaired ventricular septal defect (VSD), severe right ventricular wall hypertrophy (thicker than the left ventricular wall), and massive central pulmonary artery dilation containing in-situ mural thrombi, associated with chest wall collaterals and peripheral neovascularity.
Key takeaways
Eisenmenger's syndrome represents the end stage of congenital heart disease with a long-standing left-to-right shunt. Widespread pulmonary vascular remodeling leads to severe pulmonary hypertension, reversal of the shunt (right-to-left), and cyanosis. Key CT findings include severe RV hypertrophy, central PA dilation with in-situ thrombosis, and collateral systemic-to-pulmonary vascular connections.
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