A 9-month-old male presents with cyanotic episodes triggered by crying during venipuncture. The mother reports the infant assumes a characteristic squatting position that relieves the cyanosis. Vital signs show HR 165/min, RR 48/min, SpO2 78% during crying, BP 95/60 mmHg, temp 37.2°C. Cardiac examination reveals a harsh systolic ejection murmur at the left upper sternal border. Chest X-ray demonstrates a "boot-shaped" heart with decreased pulmonary vascularity. The infant has never received digoxin. Which of the following is the most likely diagnosis?
- A)Tetralogy of FallotGABARITO
- B)Coarctation of the aorta
- C)Patent ductus arteriosus
- D)Atrial septal defect
- E)Ventricular septal defect
Explicação
Tetralogy of Fallot is correct. Hypercyanotic spells that improve with squatting or knee chest positioning are classic because increased systemic vascular resistance reduces right to left shunting across the VSD. The lesion consists of pulmonic stenosis, right... Ver explicação completa e trilha adaptativa →