A 62-year-old breast cancer survivor visit her physician because of weakness, fatigue, fever and weight gain 5 years following her radiation therapy. The physicians also elicits complaints about abdominal discomfort and exertional dyspnea. Physical examination reveals hepatomegaly and Jaguar venous distention the fails to subside on inspiration, but show no evidence of hypotension or pulsus paradoxus. An echocardiogram shows reduced end-diastolic volume and elevated diastolic pressure in both ventricles. Which of the following is most likely the diagnosis? A.cardiac tamponade B.congestive heart failure C.constrictive pericarditis D.dilated cardiomyopathy E.recurrence of breast cancer
The correct answer is C. Constrictive pericarditis interferes with the filling of the ventricles because of granulation tissue formation in the pericardium. It can follow a viral infections, trauma, neoplastic disease, mediastinal irradiation and other chronic diseases, pericardial thickening and calcification are sometimes apparent on CT and MRI.
