Presentation
Presents with exercise intolerance, exertional coughing, and hind limb weakness following exercise. PCV is 68%.
Patient Data
The cardiac silhouette is moderately enlarged, with increased sternal contact and a reverse-D shape on the ventrodorsal projection, indicating right sided enlargement. The pulmonary vasculature is small in size. There is a diffuse bronchointerstitial pattern throughout the lungs. The mediastinum and pleural space are normal. The musculoskeletal structures appear normal.
Case Discussion
Echocardiography confirmed a patent ductus arteriosus and right ventricular enlargement, with pulmonary hypertension. This is consistent with Eisenmenger's syndrome and is not surgically correctable. Phlebotomy was recommended to reduce the PCV.
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