A 5-year-old girl with a history of uncorrected cyanotic heart disease now presents with dyspnea, syncope, and severe cyanosis. Physical examination reveals clubbing of the digits, polycythemia on CBC, and a loud single S2. Cardiac catheterization shows equal systemic and pulmonary artery pressures with bidirectional shunting. Which pathophysiologic consequence is most directly responsible for her current symptoms?
- A)Decreased systemic vascular resistance
- B)Mitral stenosis progression
- C)Pulmonary vascular disease and increased pulmonary vascular resistanceGABARITO
- D)Coronary artery disease
- E)Left ventricular hypertrophy
Explicação
This patient has developed Eisenmenger syndrome—chronic left-to-right shunting leading to pulmonary vascular disease with increased pulmonary vascular resistance. The reversal of shunt flow (right-to-left) explains the increased cyanosis and symptoms. Polycyth... Ver explicação completa e trilha adaptativa →