A 58-year-old man presents with progressive abdominal distention and lower extremity edema 10 years after mediastinal radiation therapy for lymphoma. Vitals show BP 128/92 mmHg, HR 102 bpm, RR 18/min, SpO2 98% on room air. Jugular venous pressure rises during inspiration. Echocardiography reveals a thick, calcified pericardium with septal bounce. Notably, left ventricular ejection fraction is preserved at 55%. He takes no cardiac medications. Which diagnosis best explains his clinical presentation?
- A)Dilated cardiomyopathy
- B)Heart failure with reduced ejection fraction
- C)Constrictive pericarditisGABARITO
- D)Restrictive cardiomyopathy
- E)Cardiac tamponade
Explicação
Constrictive pericarditis is correct. Prior radiation can scar and calcify the pericardium, creating a rigid shell that limits diastolic filling and produces right sided congestion with Kussmaul sign. The chronic calcified pericardium distinguishes it from tam... Ver explicação completa e trilha adaptativa →