A 73-year-old woman with chronic systolic heart failure presents with gradually worsening dyspnea over 3 days. Vital signs show BP 158/92 mmHg, HR 108, RR 22, SpO2 92% on room air. Chest radiograph demonstrates bilateral blunting of costophrenic angles. BNP is elevated at 850 pg/mL. Thoracentesis reveals transudative fluid with protein 2.2 g/dL and LDH 180 IU/L. No fever documented. Which of the following is the most likely diagnosis?
- A)Pulmonary embolism
- B)Exudative parapneumonic effusion
- C)Lung abscess
- D)Transudative pleural effusion from congestive heart failureGABARITO
- E)Empyema
Explicação
Transudative pleural effusion from congestive heart failure is correct. Heart failure raises hydrostatic pressure and produces low protein, low LDH pleural fluid by Light criteria. The bilateral effusions and known cardiac disease support a transudative mechan... Ver explicação completa e trilha adaptativa →