The case below is followed by a choice of diagnoses. Select the answer choice that best describes this patient's condition. An independent 90-year-old retired teacher with diet controlled diabetes, hypertension, and hyperlipidemia was in her usual state of health until three days prior to presentation when she developed substernal, non-radiating chest pressure at rest associated with mild nausea, malaise, and fatigue. She took an antacid for presumed dyspepsia and delayed seeking medical care until she was no longer able to ambulate around her home due to dyspnea on even minimal exertion. On presentation to the emergency department her blood pressure is 90/60, heart rate 80 bpm, respiratory rate 18/min, and oxygen saturation 100% on 2L nasal cannula. On exam, her jugular vein is distended with pulsations noted 10 cm above the right atrium. She appears comfortable and is able to answer questions in complete sentences.
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