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January 28, 1974

Eisenmenger Syndrome: An Unusual Example

Author Affiliations

Mount Sinai School of Medicine New York

JAMA. 1974;227(4):441. doi:10.1001/jama.1974.03230170057030

To the Editor.—  Eisenmenger syndrome is well defined by Wood1 as are the characteristic clinical findings of pulmonary hypertension with rightto-left shunt.2 This communication reports a case with minimal auscultatory and normal electrocardiographic findings. Normal electrocardiographic findings in a patient were first reported by Schrire,3 but his patient had other characteristic findings of the syndrome.A 32-year-old Puerto Rican man, with known congenital heart disease, reported mild to moderate exercise limitation, but otherwise was symptom-free. He was employed and worked regularly.On physical examination, there was no obvious evidence of cyanosis or clubbing. The heart was not enlarged and not hyperactive. No significant murmurs were audible. Second heart sound was of normal intensity and split normally. No diastolic murmur was audible. The lungs were clear; the liver and spleen were normal in size. The pulses were normal.The electrocardiogram was within normal limits, yet radiologic examination showed a