WBR0021

Author	PageAuthor::Aarti Narayan MBBS, Raviteja Reddy Guddeti MBBS
Exam Type	ExamType::
Main Category
Sub Category
Prompt	[[Prompt::A 50 yr old male presents to the clinic with history of fatigue, weakness, weight gain, increased abdominal girth, and swelling. History of present illness reveals orthopnea and paroxysmal nocturnal dyspnea. Past history is significant for having undergone radiotherapy for lymphoma. Blood pressure is found to be 100/60 mm Hg, respiratory rate of 15/min and HR 100 beats/min. JVP shows a prominent x and y descent. Abdominal examination shows hepatomegaly and ascites. Auscultation demonstrates distant heart sounds and EKG shows low voltage QRS complexes and fattened T wave. What is the most likely diagnosis?]]
Answer A	AnswerA::Constrictive pericarditis
Answer A Explanation	AnswerAExp::Constrictive pericarditis is the correct answer.
Answer B	AnswerB::Acute pericarditis
Answer B Explanation	AnswerBExp::Acute pericarditis is associated with severe retrosternal chest pain. History of increased abdominal girth, edema and hepatomegaly are not findings one would expect with the diagnosis of acute pericarditis.
Answer C	AnswerC::Cardiac tamponade
Answer C Explanation	AnswerCExp::
Answer D	AnswerD::Cor pulmonale
Answer D Explanation	AnswerDExp::Absence of history of a chronic pulmonary disease makes cor pulmonale a less likely diagnosis.
Answer E	AnswerE::Hypertrophic cardiomyopathy
Answer E Explanation	AnswerEExp::
Right Answer	RightAnswer::
Explanation	[[Explanation::The correct answer is constrictive pericarditis. The patients past history of irradiation for lymphoma likely caused scarring of the pericardium. Signs of right heart failure along with characteristic JVP findings suggest chronic constrictive pericarditis. Educational Objective: References: ]]
Approved	Approved::No
Keyword
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::

Image [[WBRImage::|]] Caption WBRImageCaption::no-display Position [[WBRImagePlace::|]]