Atrial Septal Defect (Ostium Secundum Type) with Eisenmenger’s Syndrome

  • Hakimeh Sadeghian
  • Zahra Savand-Roomi


A 31-year-old woman presented with dyspnea on exertion (functional class III). O2 saturation was 83 % in the room air and reached 91 % with O2. Physical examination revealed a loud S2 and clubbing. Electrocardiography showed right-axis deviation and R > S in the right precordial leads.


Pulmonary Hypertension Pulmonary Arterial Hypertension Septal Defect Functional Class Atrial Septal Defect 
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Supplementary material

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  1. 2.
    Webb GD, Smallhorn J, Therrien J, Redington AN. Congenital heart disease. In: Bonow RO, Mann D, Zipes DP, Libby P, Breunwald E, editors. Breunwarld heart disease, a text book of cardiovascular medicine. 9th ed. China: Elsevier Saunders; 2012. p. 1411–67.CrossRefGoogle Scholar
  2. 7.
    Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N, et al. ESC guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J. 2010;31(23):2915–57 [Practice Guideline].CrossRefPubMedGoogle Scholar
  3. 24.
    Jung IH, Lee SY, Lee SJ, Lee JY, Park NJ, Ahn DS, et al. Device closure of a large atrial septal defect in a patient with severe pulmonary arterial hypertension after 1 year use of an oral endothelin receptor antagonist. J Cardiovasc Ultrasound. 2013;21(3):140–4.CrossRefPubMedCentralPubMedGoogle Scholar
  4. 25.
    Bradley EA, Chakinala M, Billadello JJ. Usefulness of medical therapy for pulmonary hypertension and delayed atrial septal defect closure. Am J Cardiol. 2013;112(9):1471–6.CrossRefPubMedGoogle Scholar
  5. 26.
    Taniguchi Y, Emoto N, Miyagawa K, Nakayama K, Kinutani H, Tanaka H, et al. Subsequent shunt closure after targeted medical therapy can be an effective strategy for secundum atrial septal defect with severe pulmonary arterial hypertension: two case reports: strategy for ASD with severe PAH. Heart Vessels. 2014;29(2):282–5.CrossRefPubMedCentralPubMedGoogle Scholar
  6. 27.
    Tahara N, Mizoguchi M, Honda A, Tahara A, Nitta Y, Kodama N, et al. Successful shunt closure and improvement of hemodynamics in an ASD patient with severe pulmonary arterial hypertension and small shunt following a long-term use of bosentan. Int J Cardiol. 2012;158(2):e38–40.CrossRefPubMedGoogle Scholar
  7. 28.
    Park YK, Park JH, Yu JH, Kim JH, Lee JH, Choi SW, et al. Transient use of oral bosentan can be an additional option to reduce pulmonary arterial hypertension in a patient with severe pulmonary arterial hypertension associated with atrial septal defect. J Cardiovasc Ultrasound. 2011;19(3):159–62.CrossRefPubMedCentralPubMedGoogle Scholar
  8. 29.
    Galie N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J. 2009;34(6):1219–63 [Guideline].CrossRefPubMedGoogle Scholar
  9. 30.
    Stuart R. Pulmonary hypertension. In: Bonow RO, Mann D, Zipes DP, Libby P, Breunwald E, editors. Breunwarld heart disease, a text book of cardiovascular medicine. 9th ed. Philadelphia: Elsevier Saunders; 2012. p. 1696–718.Google Scholar
  10. 31.
    Therrien J, Rambihar S, Newman B, Siminovitch K, Langleben D, Webb G, et al. Eisenmenger syndrome and atrial septal defect: nature or nurture? Can J Cardiol. 2006;22(13):1133–6.CrossRefPubMedCentralPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Hakimeh Sadeghian
    • 1
  • Zahra Savand-Roomi
    • 2
  1. 1.Department of EchocardiographyTehran University of Medical Sciences Tehran Heart CentreTehranIran
  2. 2.Department of EchocardiographyKowsar HospitalShirazIran

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