A 56-year-old man presents with shortness of breath, fatigue, and edema. He has also noticed weight gain, abdominal discomfort, and distension. He has a prior history of lung cancer treated with radiotherapy to the chest. There is no history of liver or cardiac disease in the past. On examination, he has an elevated JVP, prominent y descent of neck veins, and positive Kussmaul sign. The heart sounds are normal. The CXR shows a normal cardiac silhouette and the ECG has low voltages.For the above patient with shortness of breath and peripheral edema, select the most likely diagnosis.
High-Yield Explanation
Constrictive pericarditis is characterized by a prominent y descent of the neck veins and low voltage on ECG. The presence of a positive Kussmaul sign helps differentiate the syndrome from cor pulmonale and restrictive cardiomyopathies.