A 34-Year-Old Russian Immigrant Visits the Doctor After Complaining of Exertional

A 34-year-old Russian immigrant visits the doctor after complaining of exertional dyspnea and progressive lower extremity swelling for two months. He also complains of abdominal distension and a loss of appetite. Over the last two months, the patient has gained 4.5 kg (10 lbs) . Past medical history is important for hypertension and recurrent lung infections that necessitate long-term antibiotic therapy. He has never had coronary artery disease. For the past 15 years, the patient has smoked a pack of cigarettes every day. He is subjected to noninvasive cardiac testing, which is followed by cardiac catheterization. The slide below depicts a jugular venous pressure tracing. 11ec160b 3a8d 1b23 9249 0f7b4d8776df MD0001 00 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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