A large spleen in a patient with heart failure.

To answer the question (refer to the previous post), a large spleen in a patient with heart failure should raise the suspicion of pericardial disease. To be more specific, constrictive pericarditis and pericardial tamponade.

If you rule out these two possibilities , then you are most probably dealing with either tricuspid valve disease ( incompetence) or subacute bacterial endocarditis.

More broadly, any cause of splenomegaly should be considered depending on clinical data.