Which of the following conditions is most likely to be associated with cannon a waves on a central venous pressure (CVP) tracing?

The normal central venous pressure (CVP) tracing consists of two downward elements (x and y) and three upward elements (a, c, v) (Figure 1, Table 1).

Large a waves, also commonly called cannon a waves (Figure 2), can be seen as a result of two different processes. Causes of cannon a waves include the right atrium contracting against a closed tricuspid valve (junctional rhythms, complete heart block, ventricular tachycardia) and increased resistance to right ventricular emptying (tricuspid stenosis, right ventricular hypertrophy, pulmonary arterial stenosis, pulmonary hypertension).

Atrial fibrillation results in the loss of the a wave on the CVP tracing.

Mitral stenosis produces no change on the CVP...

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