A 52-year-old woman with atrial fibrillation (not anticoagulated) presents to the emergency department with sudden onset dyspnea, right-sided pleuritic chest pain, and blood-tinged sputum. Vital signs: heart rate 118 bpm, respiratory rate 24 breaths/min, oxygen saturation 92% on room air. Chest X-ray shows a wedge-shaped opacity in the right lower lobe. CT pulmonary angiography confirms acute pulmonary embolism in the right lower lobe with corresponding infarction. Which of the following pathophysiologic mechanisms best explains the hemoptysis observed in this patient?
- A)Acute increase in pulmonary capillary wedge pressure from right ventricular failure causing pulmonary edema
- B)Mechanical erosion of the embolus through the pulmonary artery wall into the adjacent bronchus
- C)Alveolar hemorrhage secondary to pulmonary infarction and loss of bronchial collateral circulationGABARITO
- D)Inflammatory mediator release from activated macrophages causing diffuse alveolar damage
- E)Disseminated intravascular coagulation triggered by tissue factor release from damaged lung parenchyma
Explicação
Hemoptysis in pulmonary embolism with infarction occurs when the embolus blocks pulmonary arterial blood flow to a lung segment that has poor collateral circulation from the bronchial arteries. The affected alveoli, deprived of blood supply, undergo necrosis a... Ver explicação completa e trilha adaptativa →