What is the presumed diagnosis for a 25-year-old patient presenting with a split and fixed second heart sound, a systolic ejection murmur in the pulmonary area, right bundle branch block on electrocardiogram (ECG), and dilated pulmonary arteries with increased pulmonary vascularization on chest radiograph?

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Diagnóstico Diferencial En base a los síntomas y hallazgos clínicos presentados, se puede considerar el siguiente diagnóstico diferencial:

  • Diagnóstico más probable
  • Comunicación interauricular (a): El 2° ruido cardíaco desdoblado y fijo, junto con el soplo sistólico eyectivo en el área pulmonar, sugiere un aumento del flujo sanguíneo a través de la válvula pulmonar, lo que es consistente con una comunicación interauricular. El trastorno de conducción en rama derecha y la radiografía de tórax con arterias pulmonares dilatadas y aumento de la vascularización pulmonar también apoyan este diagnóstico.
  • Otros diagnósticos probables
  • Comunicación interventricular (b): Aunque es menos probable que la comunicación interauricular, una comunicación interventricular también puede causar un aumento del flujo sanguíneo a través de la válvula pulmonar y producir síntomas similares.
  • Ductus arterioso persistente (c): Este diagnóstico también puede causar un aumento del flujo sanguíneo a través de la válvula pulmonar, aunque el soplo sistólico eyectivo en el área pulmonar es más típico de una comunicación interauricular.
  • No debes perder (diagnósticos que no son tan probables, pero que serían mortales si se pierden)
  • Insuficiencia tricuspídea (d): Aunque es menos probable que los otros diagnósticos, la insuficiencia tricuspídea puede causar síntomas similares y debe ser considerada en el diagnóstico diferencial, especialmente si hay signos de insuficiencia cardíaca.
  • Diagnósticos raros
  • Otras anomalías cardíacas congénitas, como la tetralogía de Fallot o la transposición de los grandes vasos, pueden presentar síntomas similares, pero son menos probables en un paciente de 25 años sin antecedentes de enfermedad cardíaca congénita.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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