A 55-year-old woman is recently diagnosed with amyloidosis. She is now noticing increasing shortness of breath, fatigue, and edema. On examination, the JVP is at 10 cm with a negative Kussmaul's sign but prominent x and y descent. The blood pressure is 90/70 mm Hg, no pulsus paradoxus, pulse 100/min with low volume, and normal heart sounds.For the above patient with shortness of breath and peripheral edema, select the most likely diagnosis.: (A) cardiac tamponade, (B) constrictive pericarditis, (C) restrictive cardiomyopathy, (D) right ventricle myocardial infarction (RVMI)
Answer is C. The combination of absent pulsus and absent Kussmaul sign with prominent x descent favors a restrictive cardiomyopathy.Unlike constrictive pericarditis, restrictive cardiomyopathies frequently present with an enlarged heart, orthopnea, LVH, and bundle branch