A 61 year old man with long standing chronic lung disease presents with worsening edema and abdominal fullness. Jugular venous distention is present. Cardiac examination shows a blowing holosystolic murmur best heard at the left lower sternal border that increases with inspiration. Which of the following is the most likely mechanism of this patient's murmur?
- A)Calcific degeneration of the pulmonic valve
- B)Functional incompetence from annular dilation of the tricuspid valveGABARITO
- C)Commissural fusion from rheumatic fever
- D)Leaflet prolapse due to proteoglycan accumulation
- E)Acute rupture of the ventricular septum
Explicação
Chronic pulmonary hypertension from lung disease can cause right ventricular dilation and secondary tricuspid annular dilation, leading to functional tricuspid regurgitation. The murmur gets louder with inspiration because increased venous return augments righ... Ver explicação completa e trilha adaptativa →