An 80-year-old woman with a history of rheumatic heart disease presents with progressive fatigue and dyspnea on exertion. On exam, she has an RV lift, a diastolic decrescendo murmur, and an extra...

An 80-year-old woman with a history of rheumatic heart disease presents with progressive fatigue and dyspnea on exertion. On exam, she has an RV lift, a diastolic decrescendo murmur, and an extra “snapping” sound after S 2 . Her ECG is notable for atrial fibrillation, RVH, and LA enlargement. She appears to have an erythematous rash on her face and peripheral edema. Cardiac catheterization is performed and two intracardiac pressure transducers are placed, one in the LV and one in the LA. Which of the following hemodynamic tracings is most consistent with the patient’s diagnosis?

A. Tracing 1

B. Tracing 2

C. Tracing 3

D. Tracing 4

E. Tracing 5