A 68-year-old man with a 40-pack-year smoking history and chronic obstructive pulmonary disease presents with progressive dyspnea, orthopnea, and peripheral edema over 3 months. Physical examination reveals a loud, single S2 and a right ventricular heave. Chest radiograph shows enlarged right atrium and right ventricle. Which of the following is the most likely diagnosis?
- A)Aortic regurgitation
- B)Pulmonary hypertension with secondary tricuspid regurgitationGABARITO
- C)Pulmonary stenosis
- D)Primary mitral stenosis
- E)Rheumatic tricuspid stenosis
Explicação
Chronic hypoxia from COPD causes pulmonary vasoconstriction and remodeling, leading to pulmonary hypertension. This increases RV afterload, causing RV dilation and secondary (functional) tricuspid regurgitation. The single loud S2 reflects elevated pulmonary p... Ver explicação completa e trilha adaptativa →