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3g-1. Pulmonary Hypertension/ Eisenmenger’s syndrome. (Legend.)

A. PA radiograph demonstrates the heart is normal size with decreased pulmonary arterial markings, a prominent convex pulmonary artery and small aortic arch.

B. Right anterior oblique view shows no evidence of left atrial enlargement.

C. There is dilatation of the main pulmonary artery with decreased peripheral vascular markings.

Ventricular septal defect with pulmonary hypertension (Eisenmenger complex).

Eisenmenger’s complex is characterized by elevated pulmonary vascular resistance in the setting of a VSD secondary to long-standing left to right shunting with consequent right to left shunting resulting in cyanosis.