A 69-year-old woman complains of some atypical chest pain 2 days prior to presentation. On examination, the JVP is at 8 cm, positive Kussmaul sign, and normal heart sounds. The lungs are clear. The ECG is abnormal, and the CXR shows a normal cardiac silhouette.For the above patient with shortness of breath and peripheral edema, select the most likely diagnosis.
cardiac tamponade
constrictive pericarditis
restrictive cardiomyopathy
right ventricle myocardial infarction (RVMI)
RVMI is characterized by high neck veins, ECG abnormalities, and often a right-sided S3. The low cardiac output associated with RVMI can often be treated by volume expansion. Although a third of patients with inferoposterior infarctions have some degree of right ventricular necrosis, extensive RVMI is uncommon.
C.V.S.