A 63-year-old man develops acute shortness of breath 3 days after an inferior wall myocardial infarction. He presents with BP 92/58, HR 118/min, RR 28/min, and SpO2 82% on room air. Examination reveals flash pulmonary edema and a new loud holosystolic murmur radiating to the axilla. Chest X-ray shows pulmonary congestion. Troponin remains elevated. He denies prior cardiac history. Which of the following is the most likely diagnosis?

  1. A)Dressler syndrome
  2. B)Ventricular septal rupture
  3. C)Papillary muscle ruptureGABARITO
  4. D)Ventricular aneurysm
  5. E)Free wall rupture

Explicação

Papillary muscle rupture is correct. This complication typically occurs 2 to 7 days after MI and causes acute severe mitral regurgitation with pulmonary edema and a new apical holosystolic murmur. The posteromedial papillary muscle is especially vulnerable bec... Ver explicação completa e trilha adaptativa →

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