A 72-Year-Old Man with Long-Standing Dyspnea Was Seen in the Clinic

A 72-year-old man with long-standing dyspnea was seen in the clinic after experiencing an episode of syncope.  Physical examination showed weak and slowly rising arterial pulses.  Cardiac auscultation showed a harsh midsystolic murmur best heard at the second right intercostal space with decreased intensity of the second heart sound.  Electrocardiogram and echocardiogram confirmed the diagnosis of severe aortic stenosis.  Two months later, the patient comes to the emergency department with palpitations and increased shortness of breath.  His blood pressure is 90/60 mm Hg and his heart rate is 130/min with an irregularly irregular rhythm.  Electrocardiogram shows new-onset atrial fibrillation without significant ST-segment or T-wave changes.  Chest x-ray shows bilateral pulmonary edema.  Which of the following hemodynamic changes is most likely associated with this patient's current presentation?

A) Insidious right ventricular failure
B) Sudden decrease in left ventricular preload
C) Sudden decrease in left ventricular systolic function
D) Sudden increase in left ventricular afterload
E) Sudden increase in left ventricular filling

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free