Final answer:
b) Atrial septal defect (ASD) The cause of the symptoms including exertional shortness of breath, chest tightness, and right ventricular hypertrophy for the 31-year-old female is likely an Atrial septal defect (ASD), as it can lead to these symptoms due to right ventricular overload from a left-to-right shunt.
Step-by-step explanation:
The 31-year-old female described is experiencing exertional shortness of breath (SOB), chest tightness, right ventricular heave, bilateral pitting edema of the ankles, and ECG evidence of right ventricular hypertrophy. Considering these symptoms and signs, the most likely cause from the given options is an Atrial septal defect (ASD). ASD can lead to right ventricular overload due to the left-to-right shunt of blood, and over time, this can cause right ventricular hypertrophy, SOB, and edema as a result of chronic volume overload.
Although pulmonary embolism, chronic obstructive pulmonary disease (COPD), and mitral valve prolapse can lead to similar symptoms, the presence of ECG changes specific to right ventricular hypertrophy, together with bilateral edema and exertional symptoms, makes ASD a more likely cause in the absence of other supporting information such as pulmonary function test results or imaging indicative of embolism.In this case, the most likely cause of the patient's symptoms is pulmonary embolism (a).Pulmonary embolism occurs when a blood clot (embolus) travels to the lungs, blocking one of the pulmonary arteries. This can result in symptoms such as shortness of breath (SOB) and chest tightness.The presence of right ventricular heave on chest palpation, bilateral pitting edema of the ankles, and RV hypertrophy on ECG are all consistent with the diagnosis of pulmonary embolism.