A 42 year old woman presents with progressive exertional dyspnea and intermittent hemoptysis. She emigrated from an area where streptococcal infections were common and reports repeated sore throats as a child. Examination shows an opening snap followed by a low pitched diastolic rumble best heard at the apex in the left lateral decubitus position. Which of the following is the most likely underlying etiology?
- A)Congenital failure of ductus arteriosus closure
- B)Dystrophic calcification of a bicuspid valve
- C)Myxomatous degeneration of valve leaflets
- D)Post streptococcal autoimmune valvular scarringGABARITO
- E)Acute papillary muscle ischemia
Explicação
Mitral stenosis is classically caused by chronic rheumatic heart disease after group A streptococcal pharyngitis. The opening snap and apical diastolic rumble, together with dyspnea and hemoptysis from pulmonary venous hypertension, are classic features. Rheum... Ver explicação completa e trilha adaptativa →