Eisenmenger's Syndrome

Recommendations for Ongoing Care

Noncardiac surgery

Noncardiac surgery should be carefully planned. Having a cardiac anesthesiologist is important. Major noncardiac surgery should be done at a medical center with cardiac expertise and adult congenital cardiac consultation readily available. If intravenous (IV) therapy is used, all IV lines should have an air filter to prevent air bubbles from entering the bloodstream.

Medication

Prescription medication that can either raise or lower blood pressure requires careful monitoring. Most over-the-counter medications also may affect blood pressure and heart rate. In general, these medications are not recommended unless directed by a doctor. Recreational drug use is absolutely not recommended. Any significant decrease in blood pressure may be life threatening.

Pregnancy

Pregnancy for a woman who has Eisenmenger's syndrome is absolutely not recommended.

The patient, partner and doctors must have a careful, honest and realistic discussion of the issues of pregnancy. This should be done prior to becoming pregnant.

If a woman with Eisenmenger's syndrome gets pregnant against medical advice, the risk of death is about 50 percent. In addition there is an increased risk of spontaneous abortion, low infant birth weight and an increased likelihood of having a child with a congenital heart defect.

Contraceptives must be chosen carefully. Many types of birth control pills will increase the risk of forming blood clots. Some can also raise blood pressure. A tubal ligation may be the safest option for many women. If this is chosen, it should be done using cardiac anesthesia at a medical center experienced in treating congenital heart disease.