Digoxin This is a drug which increases the force of contraction of the heart muscle and helps it work more effectively.
Venesection This is a procedure by which some of the blood is removed from the patient, and may or may not be replaced by plasma or other fluids. By removing some of the blood which contains high levels of haemoglobin (red cells), this reduces the concentration of red cells. In some patients this can be quite effective, and the body may take several months to reproduce the number of red cells. In others the red cells are replaced far more quickly. There is the possibility of the patient going into shock as a result of the treatment, so cardiologists are cautious about its use, and the benefits need to be weighed against the possible risks with each individual.
Oxygen The use of oxygen, usually by mask or nasal cannula can be effective in raising the blood saturation (oxygen level) and reducing the workload on the heart. Many patients benefit from using oxygen overnight when it does not prohibit activity, and this gives their body ‘a boost’ for the following day.
Pulmonary Vasodilators There are some new developments for children and young adults with Eisenmengers. Drugs are undergoing trials to see whether they are effective in Down’s syndrome and Eisenmengers.
Follow up Advice
It is important for patients to avoid becoming dehydrated, and for them to be carefully monitored during any medical or dental procedures, and appropriate antibiotic cover givenPrognosis
Whilst there is no treatment to cure the underlying problem, the treatments mentioned above may be quite effective in helping to lessen the symptoms. Although there is of course variation in patients, it is possible for someone with Down’s Syndrome who has Eisenmengers Complex, to survive for many years with a quite reasonable quality of life, although probably with reduced activity levels.(published with permission in writing from:http://www.dhg.org.uk)
