A 26-year-old tall man with long extremities and prior lens dislocation presents with acute severe tearing chest pain radiating to the back after weightlifting. Vital signs: BP 165/95 mmHg, HR 102/min, RR 20/min, SpO2 98% on room air. Chest X-ray shows widened mediastinum. Cardiac exam reveals no murmur. He denies recent cocaine use. Which histologic abnormality of connective tissue most likely predisposed him to this acute aortic dissection?
- A)Transmural neutrophilic infiltrates of the intima
- B)Medial degeneration with fragmentation of elastic fibersGABARITO
- C)Immune complex deposition in medium sized arteries
- D)Granulomatous inflammation with giant cells in the media
- E)Atherosclerotic calcification limited to the adventitia
Explicação
Marfan syndrome predisposes to aortic dissection because of cystic medial degeneration with fragmentation of elastic tissue in the aortic wall. This weakens the media and facilitates propagation of blood after an intimal tear. His habitus and lens dislocation ... Ver explicação completa e trilha adaptativa →