A 63-year-old woman presents with episodic flushing, chronic diarrhea, and wheezing. She reports progressive fatigue and bilateral leg edema. Vital signs: BP 118/76 mmHg, HR 102 bpm, RR 20/min, SpO2 94% on room air. Cardiac examination reveals a holosystolic murmur at the left lower sternal border that increases with inspiration. Chest X-ray shows pulmonary congestion. Notably, no fever is present. Which of the following is the most likely cause of her valvular lesion?
- A)Serotonin mediated fibrous deposits on right sided valvesGABARITO
- B)Autoimmune destruction after pharyngitis
- C)Calcification of a congenital bicuspid valve
- D)Papillary muscle rupture after inferior MI
- E)Acute bacterial invasion after dental extraction
Explicação
Carcinoid syndrome causes serotonin mediated fibrous thickening of right sided valves, especially the tricuspid and pulmonic valves, producing tricuspid regurgitation that increases with inspiration. The flushing and diarrhea identify the neuroendocrine source... Ver explicação completa e trilha adaptativa →