A 68-year-old man with a history of myocardial infarction 2 weeks ago presents with acute dyspnea, hypotension, and a new holosystolic murmur at the left lower sternal border. Pulmonary edema is evident on chest X-ray. Echocardiography shows a ventricular septal defect with left-to-right shunting. Which of the following complications explains his acute presentation?
- A)Development of left ventricular free wall rupture
- B)Rupture of the ventricular septum from infarction and necrosisGABARITO
- C)Spontaneous closure of the VSD
- D)Mechanical mitral regurgitation from papillary muscle dysfunction
- E)Ischemic mitral stenosis from annular dilation
Explicação
Ventricular septal rupture is a devastating complication of acute myocardial infarction occurring 2-14 days post-MI. The infarcted myocardium becomes necrotic and ruptures, creating a defect. The acute left-to-right shunt causes sudden pulmonary edema, hypoten... Ver explicação completa e trilha adaptativa →