A patient with history of ankle edema, shortness of breath and orthopnea, is probably suffering from:

 # A patient with history of ankle edema, shortness of breath and orthopnea, is probably suffering from:

A. Asthma

B. Emphysema

C. Cardiac decompensation

D. Constrictive pericarditis

The correct answer is C. Cardiac decompensation. 

Ankle edema is a common sign of fluid accumulation in the body, which can occur in a variety of conditions. Shortness of breath and orthopnea, or difficulty breathing when lying down, can be indicative of heart failure or other cardiac issues. Asthma and emphysema are respiratory conditions that can also cause shortness of breath, but they do not typically present with ankle edema or orthopnea. Constrictive pericarditis is a rare condition characterized by inflammation and thickening of the pericardium, the sac surrounding the heart, which can cause heart failure-like symptoms, but it is less common than cardiac decompensation.

Reference: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine, 20th Edition. New York, NY: McGraw-Hill Education; 2018. Chapter 298, Heart Failure and Cor Pulmonale.