What is the trigger for angina pectoris?

A. Expecting copious amounts of frothy, pink sputum: This symptom is typically associated with left-sided heart failure or pulmonary edema, where fluid accumulates in the lungs, leading to the production of frothy, pink sputum. It is not a classic manifestation of right-sided heart failure.

B. Fine crackles throughout both lung fields: Fine crackles are more indicative of left-sided heart failure due to fluid accumulation in the lungs (pulmonary congestion). In right-sided heart failure, the primary issues relate more to systemic congestion rather than pulmonary congestion.

C. +pitting edema in lower extremities: Right-sided heart failure often leads to fluid retention and peripheral edema due to increased venous pressure. Pitting edema in the lower extremities is a common clinical manifestation in patients with cor pulmonale and right-sided heart failure.

D. Altered level of consciousness: This can occur due to decreased cardiac output and resulting reduced cerebral perfusion. In right-sided heart failure, especially in advanced stages, fluid overload can lead to increased intracranial pressure, contributing to altered mental status.

E. Jugular vein distention: Jugular vein distention is a classic sign of right-sided heart failure. Increased pressure in the right atrium due to fluid overload results in distended neck veins, indicating elevated venous pressure.

A. Acute pericarditis: Acute pericarditis is characterized by inflammation of the pericardium, often presenting with pleuritic chest pain, pericardial friction rub, and diffuse ST-segment elevations on ECG. It does not typically involve pericardial thickening or chronic symptoms such as pitting edema and dyspnea on exertion.

B. Constrictive pericarditis: Chronic pericarditis with pericardial thickening suggests constrictive pericarditis, a condition where the pericardium becomes rigid and fibrotic, impairing diastolic filling and leading to heart failure symptoms such as peripheral edema, crackles in the lungs, and dyspnea on exertion. The echocardiogram findings confirm this diagnosis.

C. Pericardial effusion: Pericardial effusion refers to the accumulation of excess fluid in the pericardial sac, which can lead to cardiac tamponade if severe. However, the presence of pericardial thickening rather than fluid accumulation suggests constrictive pericarditis rather than an isolated effusion.

D. Effusion-constrictive pericarditis: This condition involves both pericardial effusion and constrictive pericarditis. While it may share some features with constrictive pericarditis, the case description primarily highlights pericardial thickening rather than significant effusion, making constrictive pericarditis the more accurate diagnosis.