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Constrictive Pericarditis — EECC MCQ

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ModeratePericardial DiseaseConstrictive PericarditisEECC

A 60-year-old man presents with progressive breathlessness, peripheral oedema, and ascites. JVP is markedly elevated with a prominent y-descent. Heart sounds are quiet. Echocardiography shows a thickened pericardium with septal bounce and respiratory variation in mitral inflow velocities. LVEF is 60%. What is the most likely diagnosis and definitive treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Constrictive pericarditis; pericardiectomy

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · E = shown as D · B = shown as E

Elevated JVP with prominent y-descent, peripheral oedema, ascites, quiet heart sounds, thickened pericardium, septal bounce, and respiratory variation in mitral inflow are classic for constrictive pericarditis. Pericardiectomy is the definitive treatment (Class I). Restrictive cardiomyopathy (A) would not show a thickened pericardium. Tamponade (C) would show pulsus paradoxus and diastolic collapse. TR (D) and SVC syndrome (E) have different presentations.

Reference: ESC (2025): Guidelines for the Management of Myocarditis and Pericarditis