A 67 year old man is hospitalized for an acute transmural myocardial infarction. Two days later, he develops sudden pulmonary edema and hypotension. Examination shows a new holosystolic murmur best heard at the apex and radiating to the axilla. Which of the following is the most likely cause of this acute valvular complication?

  1. A)Myxomatous degeneration of the posterior leaflet
  2. B)Rupture of the posteromedial papillary muscleGABARITO
  3. C)Calcification of the mitral annulus
  4. D)Fibrosis of the chordae after rheumatic fever
  5. E)Vegetation on the tricuspid valve

Explicação

Papillary muscle rupture is a classic mechanical complication occurring several days after myocardial infarction and causes acute severe mitral regurgitation. The posteromedial papillary muscle is especially vulnerable because it has a single blood supply. Sud... Ver explicação completa e trilha adaptativa →

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