A 48-year-old man with history of inferior myocardial infarction three days ago presents with acute dyspnea and orthopnea. Vital signs show BP 98/62, HR 118, RR 22, SpO2 89% on room air. Bilateral rales are appreciated on lung auscultation. A new holosystolic apical murmur increases with handgrip maneuver. Chest radiography demonstrates pulmonary edema. Transthoracic echocardiography reveals papillary muscle rupture with normal aortic valve. Which of the following is the most likely diagnosis?
- A)Acute mitral regurgitation from papillary muscle ruptureGABARITO
- B)Mitral stenosis from valve inflammation
- C)Aortic regurgitation from aortic root dissection
- D)Ventricular septal defect from septal rupture
- E)Tricuspid regurgitation from right ventricular infarction
Explicação
Acute mitral regurgitation from papillary muscle rupture is a mechanical complication of acute MI, typically occurring 2-7 days post-infarction. It presents with a new holosystolic murmur at the apex that increases with handgrip (increases afterload and regurg... Ver explicação completa e trilha adaptativa →