A patient of moderate VSD in chronic CCF develops clubbing with no cyanosis. Diagnosis is: (A) Shunt reversal, (B) Long standing pulmonary edema, (C) SABE, (D) Pulmonary aery hypeension
Answer is C. SHUNT REVERSAL / EISENMENGER SYNDROME: Refers to patients with the septal defect in which blood is shunted paially or completely from right to left as a result of the development of pulmonary vascular disease resulting in apparent cyanosis.Long-standing pulmonary edema is characterized by cyanosis, dyspnea.New onset clubbing without cyanosis in a patient with congenital hea defects indicates the development of SABE .Pulmonary aerial hypeension commonly occurs in large non-restrictive VSD and is unlikely in moderate VSD.