A 60-year-old man with severe osteoporosis and chronic kidney disease presents with dyspnea on exertion and a systolic ejection murmur at the right upper sternal border. Echocardiography reveals a heavily calcified aortic valve with severely reduced leaflet mobility and an ejection fraction of 45%. Laboratory studies show elevated phosphate and calcium-phosphate product. Which of the following pathologic processes best accounts for his aortic valve disease?
- A)Syphilitic aortitis with valve involvement
- B)Endocarditis with valve destruction
- C)Degenerative calcific aortic stenosisGABARITO
- D)Bicuspid aortic valve with calcification
- E)Acute rheumatic fever with commissural fusion
Explicação
Calcific aortic stenosis in the setting of chronic kidney disease and abnormal mineral metabolism leads to secondary hyperparathyroidism and progressive valve calcification. This results in reduced leaflet mobility and stenosis. Degenerative changes with heavy... Ver explicação completa e trilha adaptativa →