A 2-year-old boy with Down syndrome is brought to the physician by his mother for a follow-up examination. His blood pressure is increased in the upper extremities and decreased in the lower extremities. His temperature is 37.0°C, heart rate is 104/min, and respiratory rate is 24/min. Physical examination shows cyanosis of the lower extremities. An AP x-ray of the chest shows notching of the inferior surfaces of the 3rd through 8th ribs. The diagnosis of left ventricular hypertrophy is suspected. Which of the following is the most likely underlying abnormality in this patient?
- A)Atrial septal defect
- B)Coarctation of the aortaGABARITO
- C)Persistent truncus arteriosus
- D)Tetralogy of Fallot
- E)Transposition of the great arteries
Explicação
Coarctation of the aorta causes upper extremity hypertension with lower extremity hypotension due to obstruction of aortic flow distal to the left subclavian artery. Collateral vessels develop through intercostal arteries, eroding the inferior surfaces of ribs... Ver explicação completa e trilha adaptativa →