A 6-week-old premature infant born at 28 weeks presents with worsening respiratory distress and signs of congestive heart failure. Vital signs: HR 165/min, RR 58/min, BP 58/32 mmHg, SpO2 88% on supplemental oxygen. Auscultation reveals a continuous "machinery" murmur. Chest X-ray shows pulmonary edema and cardiomegaly. The mother reports taking indomethacin for migraines throughout pregnancy. No cyanosis is noted. Which diagnosis best explains these findings?

  1. A)Patent ductus arteriosusGABARITO
  2. B)Tetralogy of Fallot
  3. C)Ventricular septal defect
  4. D)Coarctation of the aorta
  5. E)Atrial septal defect

Explicação

Patent ductus arteriosus (PDA) is common in premature infants with respiratory distress syndrome. The patent ductus allows left-to-right shunting, worsening pulmonary edema and respiratory status. The continuous murmur is pathognomonic. Indomethacin during pre... Ver explicação completa e trilha adaptativa →

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