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Constrictive pericarditis — RCPSC IM MCQ

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HardCardiologyConstrictive pericarditisRCPSC IM

A 54-year-old man has progressive abdominal distension, ankle swelling and exertional dyspnea 2 years after mediastinal radiotherapy for lymphoma. JVP is elevated with a prominent y descent and Kussmaul sign. Echocardiography shows septal bounce, respiratory variation in mitral inflow and preserved ejection fraction. CT chest shows pericardial calcification. What is the most likely diagnosis?

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Correct answer: E — Constrictive pericarditis

Radiotherapy, right-sided congestion, Kussmaul sign, septal bounce, respiratory Doppler variation and pericardial calcification support constrictive pericarditis rather than myocardial restriction.

Reference: Royal College Internal Medicine competencies; CCS pericardial disease resources