Physical exam-constrictive pericarditis

• ↑ JVP,
• prominent y descent,
• ⊕ Kussmaul sign 吸氣時 JVP 沒辦法下降
• Ddx:
  • tricuspid stenosis,
  • acute cor pulmonale,
  • RV dysfxn (CMP, RV MI),
  • SVC syndrome
• Hepatosplenomegaly, ascites, peripheral edema. Consider in Ddx of idiopathic cirrhosis.
• PMI usually not palpable, pericardial knock, usually no pulsus paradoxus