A 27-year-old woman presents with 6 months of progressive exertional dyspnea and near syncope. Vital signs show BP 118/76 mmHg, HR 108 bpm, RR 24/min, SpO2 88% on room air. Examination reveals a loud pulmonic component of S2 and right ventricular heave. Chest X-ray shows normal cardiac silhouette without pulmonary infiltrates. Echocardiography demonstrates elevated pulmonary artery pressure without left-sided heart disease or intracardiac shunting. Which diagnosis best explains these findings?

  1. A)Primary pulmonary hypertension due to BMPR2 mutationGABARITO
  2. B)Chronic thromboembolic pulmonary hypertension
  3. C)Spontaneous pneumothorax
  4. D)Pulmonary embolism
  5. E)Pulmonary edema due to left sided heart failure

Explicação

Primary pulmonary hypertension due to BMPR2 mutation is correct. A young woman with progressive dyspnea, loud P2, and isolated pulmonary arterial hypertension without left sided disease fits this classic presentation. The disease involves vascular smooth muscl... Ver explicação completa e trilha adaptativa →

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