Sindrome di Eisenmenger: differenze tra le versioni
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{{A|informazioni minime|medicina|gennaio 2010|firma=[[Utente:Senpai|<span style="color:black;">'''Senpai - せんぱい'''</span>]] [[Discussioni_utente:Senpai|<span style="color:black;">'''scrivimi'''</span>]] 17:53, 7 gen 2010 (CET)}} |
{{A|informazioni minime|medicina|gennaio 2010|firma=[[Utente:Senpai|<span style="color:black;">'''Senpai - せんぱい'''</span>]] [[Discussioni_utente:Senpai|<span style="color:black;">'''scrivimi'''</span>]] 17:53, 7 gen 2010 (CET)}} |
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{{T|lingua=inglese|argomento=medicina|data=marzo 2010}} |
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La '''sindrome di Eisenmerger''' è un processo morboso nel quale uno [[Shunt_(medicina)|shunt]] sinistro-destro causato da un difetto del [[setto]] [[ventricolare]] del cuore causa un incremento del flusso sanguigno attraverso il sistema vascolare polmonare, con conseguente [[ipertensione]] polmonare<ref name="pmid19416617">{{cite journal |author=Jensen AS, Iversen K, Vejlstrup NG, Hansen PB, Søndergaard L |title=[Eisenmenger syndrome] |language=Danish |journal=[[Ugeskrift for Laeger]] |volume=171 |issue=15 |pages=1270–5 |year=2009 |month=April |pmid=19416617 |doi= |url= |issn= |accessdate=2009-06-02}}</ref><ref>{{DorlandsDict|nine/000952281|Eisenmenger syndrome}}</ref>, il quale a sua volta causa l'aumento della pressione nella parte destra del cuore e conseguente inversione dello shunt a destro-sinistro. |
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[[Reazione]] [[Tessuto connettivo|fibrosa]] [[cicatrizzazione|cicatriziale]] [[ipertrofia|ipertrofica]] delle [[arteria|arterie]] della [[circolazione polmonare]] che si instaura come risposta all'[[ipertensione]]. |
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[[Image:ClubbingFingers1.jpg|right|thumb|250px|Deformazioni delle dita in un paziente con la sindrome di Eisenmenger; descritta per la prima volta da [[Ippocrate]], questa deformazione è conosciuta anche come '''dita di Ippocrate''']] |
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==Note== |
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<references/> |
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'''Eisenmenger's syndrome''' (or '''Eisenmenger's reaction''') is defined as the process in which a [[Cardiac shunt|left-to-right shunt]] caused by a [[ventricular septal defect]] in the heart causes increased flow through the pulmonary [[vasculature]], causing [[pulmonary hypertension]],<ref name="pmid19416617">{{cite journal |author=Jensen AS, Iversen K, Vejlstrup NG, Hansen PB, Søndergaard L |title=[Eisenmenger syndrome] |language=Danish |journal=[[Ugeskrift for Laeger]] |volume=171 |issue=15 |pages=1270–5 |year=2009 |month=April |pmid=19416617 |doi= |url= |issn= |accessdate=2009-06-02}}</ref><ref>{{DorlandsDict|nine/000952281|Eisenmenger syndrome}}</ref> which in turn, causes increased pressures in the right side of the heart and reversal of the shunt into a [[right-to-left shunt]]. |
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[[Image:ClubbingFingers1.jpg|right|thumb|250px|Clubbing of fingers in a patient with Eisenmenger's syndrome; first described by [[Hippocrates]], clubbing is also known as "Hippocratic fingers"]] |
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It can cause serious complications in [[pregnancy]],<ref name="pmid18466628">{{cite journal |author=Siddiqui S, Latif N |title=PGE1 nebulisation during caesarean section for Eisenmenger's syndrome: a case report |journal=J Med Case Reports |volume=2 |issue= |pages=149 |year=2008 |pmid=18466628 |pmc=2405798 |doi=10.1186/1752-1947-2-149 |url=http://www.jmedicalcasereports.com/content/2//149}}</ref> though successful delivery has been reported.<ref name="pmid17195894">{{cite journal |author=Makaryus AN, Forouzesh A, Johnson M |title=Pregnancy in the patient with Eisenmenger's syndrome |journal=Mt. Sinai J. Med. |volume=73 |issue=7 |pages=1033–6 |year=2006 |month=November |pmid=17195894 |doi= |url=http://www.mssm.edu/msjournal/73/7371033.shtml}}</ref> |
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==Etymology== |
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Eisenmenger's syndrome was so [[eponym|named]]<ref>Wood, P. ''Pulmonary hypertension with special reference to the vasoconstrictive factor.'' Br Heart J 1958;20:557-570. PMID 13584643</ref> by Dr. Paul Wood after Dr. Victor Eisenmenger, who first described<ref>Eisenmenger V. ''Die angeborenen Defekte der Kammerscheidewände des Herzens. |
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The condition was first mentioned by Hippocrates, the Greek physician.'' |
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Zeitschr Klin Med 1897;32(Supplement):1-28.</ref> the condition in 1897.<ref>{{WhoNamedIt|synd|3034}}</ref> |
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==Etiology== |
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A number of congenital heart defects can cause Eisenmenger's syndrome, including [[atrial septal defect]]s, [[ventricular septal defect]]s, [[patent ductus arteriosus]], and more complex types of acyanotic [[heart disease]].<ref name="pmid19416617"/> |
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===Pathogenesis=== |
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The left side of the heart supplies blood to the whole body, and as a result has higher pressures than the right side, which supplies only deoxygenated blood to the lungs. If a large anatomic defect exists between the sides of the heart, blood will flow from the left side to the right side. This results in high blood flow and pressure travelling through the lungs. The increased pressure causes damage to delicate capillaries, which then are replaced with scar tissue. Scar tissue does not contribute to oxygen transfer, therefore decreasing the useful volume of the pulmonary vasculature. The scar tissue also provides less flexibility than normal lung tissue, causing further increases in blood pressure, and the heart must pump harder to continue supplying the lungs, leading to damage of more capillaries. |
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The reduction in oxygen transfer reduces [[oxygen saturation]] in the blood, leading to increased production of red blood cells in an attempt to bring the oxygen saturation up. The excess of red blood cells is called [[polycythemia]]. Desperate for enough circulating oxygen, the body begins to dump immature red cells into the blood stream. Immature red cells are not as efficient at carrying oxygen as mature red cells, and they are less flexible, less able to easily squeeze through tiny capillaries in the lungs, and so contribute to death of pulmonary capillary beds. The increase in red blood cells also causes [[hyperviscosity syndrome]]. |
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A person with Eisenmenger's Syndrome is paradoxically subject to the possibility of both uncontrolled bleeding due to damaged capillaries and high pressure, and random clots due to hyperviscosity and [[stasis (medicine)|stasis]] of blood. The rough places in the heart lining at the site of the septal defects/shunts tend to gather platelets and keep them out of circulation, and may be the source of random clots. |
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Eventually, due to increased resistance, pulmonary pressures may increase sufficiently to cause a reversal of blood flow, so blood begins to travel from the right side of the heart to the left side, and the body is supplied with deoxygenated blood, leading to [[cyanosis]] and resultant organ damage. |
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==References== |
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{{Reflist}} |
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==External links== |
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* [http://www.mayoclinic.org/eisenmengers-syndrome/about.html Mayo Clinic], "Detailed Description of Eisenmenger's Syndrome" |
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* [http://www.dhg.org.uk/eisenmengercomplex.htm Down's Heart Group], "Easily understood description of Eisenmenger's Syndrome and how it affects people with Down's Syndrome who have unoperated congenital heart defects." |
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* {{Chorus|00529}} |
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{{Congenital malformations and deformations of circulatory system}} |
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{{DEFAULTSORT:Eisenmenger's Syndrome}} |
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[[Category:Cardiology]] |
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[[bg:Синдром на Айзенменгер]] |
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[[de:Eisenmenger-Reaktion]] |
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[[es:Síndrome de Eisenmenger]] |
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[[fr:Syndrome d'Eisenmenger]] |
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[[nl:Syndroom van Eisenmenger]] |
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[[ja:アイゼンメンゲル症候群]] |
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[[nn:Eisenmengers syndrom]] |
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[[pl:Zespół Eisenmengera]] |
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[[Categoria:Malattie dell'apparato respiratorio]] |
[[Categoria:Malattie dell'apparato respiratorio]] |
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Versione delle 21:39, 21 mar 2010
Questa pagina è stata proposta per la cancellazione.
Questa voce sull'argomento medicina è da aiutare.
La sindrome di Eisenmerger è un processo morboso nel quale uno shunt sinistro-destro causato da un difetto del setto ventricolare del cuore causa un incremento del flusso sanguigno attraverso il sistema vascolare polmonare, con conseguente ipertensione polmonare[1][2], il quale a sua volta causa l'aumento della pressione nella parte destra del cuore e conseguente inversione dello shunt a destro-sinistro.
Note
- ^ (Danish) Jensen AS, Iversen K, Vejlstrup NG, Hansen PB, Søndergaard L, [Eisenmenger syndrome], in Ugeskrift for Laeger, vol. 171, n. 15, April 2009, pp. 1270–5. Lingua sconosciuta: Danish (aiuto);
- ^ Template:DorlandsDict