Eisenmenger Syndrome is a rare constellation of symptoms due to untreated congenital heart disease with right to left shunt and increased pulmonary arterial hypertension. A female of 58 years old came to ER with respiratory failure and upon evaluation found to have Eisenmenger syndrome. Intensive work up concluded in medical management with patient. Eisenmenger syndrome patients’ need to be closely monitored once diagnosed owing to decreased life expectancy. |