A 65-year-old patient with a history of coronary artery bypass graft surgery 1 year ago presents with fatigue, dyspnea, and progressive lower extremity edema. Examination reveals a blood pressure of...

A 65-year-old patient with a history of coronary artery bypass graft surgery 1 year ago presents with fatigue, dyspnea, and progressive lower extremity edema. Examination reveals a blood pressure of 120/70 mm Hg and a pulse of 77 beats per minute. Th e lungs are clear. Th e heart is quiet, with normal fi rst and second heart sounds and no murmurs. Th e jugular venous pressure ( JVP) is elevated at midneck (approximately 20 cm water). Th ere is an increase in the JVP with inspiration with a rapid descent. What does this combination of fi ndings strongly suggest? a. Heart failure due to biventricular dysfunction b. Superior vena cava syndrome c. Constrictive pericarditis d. Failure of the bypass graft s and recurrent coronary artery disease