A 34-Year-Old Russian Immigrant Comes to the Physician with a 2-Month

A 34-year-old Russian immigrant comes to the physician with a 2-month history of exertional dyspnea and progressive lower extremity swelling.  He also reports abdominal distension and decreased appetite.  The patient has gained 4.5 kg (10 lbs) over the last 2 months.  Past medical history is significant for hypertension and recurrent lung infections requiring prolonged antibiotic therapy.  He has no history of coronary artery disease.  The patient has smoked a pack of cigarettes daily for the past 15 years.  He undergoes noninvasive cardiac testing followed by cardiac catheterization.  A jugular venous pressure tracing is shown on the slide below. The waveform indicated by the arrow most likely corresponds to which of the following?

A) Atrial contraction
B) Carotid pulse upstroke
C) Isovolumetric ventricular contraction
D) Tricuspid valve closure
E) Tricuspid valve opening

Correct Answer:

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