A previously healthy patient presents with dyspnea and low grade fever since 4 months. His lungs are clear. JVP is normal. ECG showed low voltage complexes. What is the possible diagnosis?
**Core Concept**
The patient's presentation of dyspnea, low-grade fever, and clear lungs for 4 months, along with a normal JVP and low voltage complexes on ECG, points towards a condition characterized by subacute inflammation of the pericardium, leading to fibrosis and calcification.
**Why the Correct Answer is Right**
The patient's symptoms are suggestive of constrictive pericarditis, a condition where the pericardium becomes thickened and fibrotic, leading to impaired diastolic filling of the heart and subsequent symptoms of heart failure. The low voltage complexes on ECG are due to the thickened pericardium acting as a barrier to the electrical impulses, reducing the amplitude of the complexes. The clear lungs and normal JVP help to rule out other causes of heart failure.
**Why Each Wrong Option is Incorrect**
**Option A:** Tuberculosis pericarditis typically presents with high fever, night sweats, and weight loss, which are not seen in this patient. Additionally, it usually has a more acute presentation.
**Option B:** Cardiac tamponade would present with elevated JVP, muffled heart sounds, and possibly pulsus paradoxus, which are not seen in this patient.
**Option C:** Hypothyroidism can cause pericardial effusion, but it would not typically present with low voltage complexes on ECG.
**Clinical Pearl / High-Yield Fact**
Constrictive pericarditis can be a complication of previous cardiac surgery, tuberculosis, or trauma, and it requires prompt treatment with anti-inflammatory agents and possibly pericardiectomy.
**Correct Answer:** C. Constrictive pericarditis.