A 3-month-old boy presents with poor feeding and tachypnea for 2 weeks. Vital signs show HR 160 bpm, RR 52/min, BP 85/55 mmHg, SpO2 94% on room air, and normal temperature. Physical examination reveals a harsh holosystolic murmur at the left lower sternal border. Chest X-ray demonstrates pulmonary edema and cardiomegaly. Echocardiography confirms a defect in the interventricular septum. The patient takes no chronic medications. Which diagnosis best explains these findings?

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

Explicação

Ventricular septal defect is correct. A harsh holosystolic murmur at the left lower sternal border is classic for a VSD, and larger defects can produce symptoms of pulmonary overcirculation and heart failure in infancy. It is the most common congenital heart d... Ver explicação completa e trilha adaptativa →

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