Eisenmenger syndrome is associated with irreversible increase in pulmonary vascular resistance causing
reduced survival. Bosentan, a non-selective endothelin receptor antagonist is the commonly used specific pulmonary
arterial hypertension drug in Eisenmenger syndrome. In this paper, we present a case of recurrent gastrointestinal bleeding
in a 23-year-old female with Eisenmenger syndrome who was only under bosentan treatment, which has not been reported
previously. Most common adverse effect of bosentan is elevation in the liver enzymes however, bleeding complication is
very rare. On the contrary, it was proposed that bosentan might be a potential protector against hyperacidity and mucosal
erosion that occur as a consequence of stress. Although the mechanistic relationship of bleeding tendency and role of
Eisenmenger syndrome concomitant with bosentan treatment is far from conclusive statement for now, this association
warrants and should draw attention of clinicians and researches in this field.
Keywords: Bosentan, congenital heart disease, eisenmenger, gastrointestinal bleeding, pulmonary hypertension.
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