A 29 year old tall thin man presents with exertional dyspnea and a sensation of chest pounding. He has hyperextensible joints and long fingers. Cardiac examination shows an early diastolic blowing murmur at the left sternal border. Echocardiography shows dilation of the ascending aorta with poor coaptation of otherwise normal aortic valve cusps. Which of the following is the most likely mechanism of this patient's valvular lesion?
- A)Cystic medial degeneration causing aortic root enlargementGABARITO
- B)Myxomatous degeneration of the chordae tendineae
- C)Fibrous thickening of valve leaflets due to carcinoid syndrome
- D)Post inflammatory commissural fusion
- E)Congenital malalignment of the conotruncal septum
Explicação
This patient with marfanoid features has aortic root dilation causing secondary aortic regurgitation. The mechanism is cystic medial degeneration of the aortic media, which enlarges the root and prevents proper closure of the aortic cusps. The diastolic murmur... Ver explicação completa e trilha adaptativa →