A 76 year old man presents with several months of exertional chest pain and two episodes of near syncope while climbing stairs. He has a history of hyperlipidemia and smoking. Blood pressure is 132/78 mm Hg. Cardiac examination shows a harsh crescendo decrescendo systolic murmur at the right upper sternal border that radiates to both carotids. The carotid upstroke is delayed and diminished. Which of the following is the most likely underlying cause of this patient's condition?
- A)Immune mediated destruction of the aortic media
- B)Fibroelastic thickening from chronic hypertension alone
- C)Dystrophic calcification of a degenerating tricuspid aortic valveGABARITO
- D)Myxomatous degeneration of the mitral valve
- E)Congenital failure of endocardial cushion fusion
Explicação
In an older adult with angina, syncope, dyspnea, and a systolic ejection murmur radiating to the carotids, the diagnosis is calcific aortic stenosis. The usual mechanism is dystrophic calcification of a previously normal tricuspid aortic valve or a bicuspid va... Ver explicação completa e trilha adaptativa →