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Aortography confirmed a normal course of coronary arteries, with adequate perfusion of essential branches and no evidence of stenosis or aneurysms. The most probable etiology appears to be a congenital lesion. Additionally, a complication of pericarditis cannot be entirely ruled out.
That occurs in right heart failure and constrictive pericarditis. Constrictive pericarditis is an important cause for Kussmaul sign or inspiratory increase in jugular venous pressure. The Y descent is shallow in tricuspid stenosis, and absent in cardiac tamponade. A prominent A wave can occur when the atrium is hypertrophied.
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