A 5-year-old girl born to a mother with first-trimester rubella infection presents with cataracts, sensorineural deafness, and a continuous "machinery" murmur at the left infraclavicular region. Vital signs show HR 110/min, BP 125/70 mmHg with bounding pulses and wide pulse pressure, RR 22/min, and SpO2 98% on room air. She denies dyspnea. Chest X-ray reveals pulmonary congestion. Echocardiography confirms a hemodynamically significant left-to-right shunt. Which diagnosis is most likely?

  1. A)Pulmonary artery stenosis
  2. B)Ventricular septal defect with pulmonary hypertension
  3. C)Aortic stenosis with aortic insufficiency
  4. D)Atrial septal defect with anomalous pulmonary venous return
  5. E)Patent ductus arteriosus as part of congenital rubella syndromeGABARITO

Explicação

Congenital rubella syndrome causes a classic triad of cardiac, ocular, and auditory manifestations. Patent ductus arteriosus is the most common cardiac lesion in congenital rubella, occurring in ~40% of infected infants. The continuous murmur, bounding pulses,... Ver explicação completa e trilha adaptativa →

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