A 6-month-old boy presents with poor feeding and failure to thrive. Vital signs show HR 145 bpm, BP 95/55 mmHg with widened pulse pressure, RR 52/min, and SpO2 92% on room air. Physical examination reveals a continuous 'machinery' murmur at the left infraclavicular area with bounding femoral pulses. Chest X-ray demonstrates pulmonary edema. Echocardiography shows left atrial enlargement. Cyanosis is absent. Which diagnosis is most likely?

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

Explicação

Patent ductus arteriosus (PDA) presents with a continuous 'machinery' or 'train-whistle' murmur heard throughout systole and diastole at the left infraclavicular region. The left-to-right shunt causes widened pulse pressure (increased systolic, decreased diast... Ver explicação completa e trilha adaptativa →

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