A 66-year-old man with aortic stenos is arrives in the ICU after repair of anabdominal aortic aneurysm. Shortly after admission, his ECG shows a change from normal sinus rhythm to atrial fibrillation at a ventricular rate of 84 beats/min. His blood pressure shows a slight change from 110/60 mm Hg to 100/52 mm Hg. Pulmonary artery occlusion pressure (PAOP) increased from 16 to 22 mm Hg with prominent a waves noted.
Which of the following is the most appropriate course of action?
A. Increase myocardial contractility with inotropic support.
B. Maintain PAOP below 20 mmHg with diuresis.
C. Attempt conversion to sinus rhythm with amiodarone.
D. Decrease peripheral vascular resistance with vasodilator therapy.
答案解析：
在主动脉瓣狭窄的治疗中，维持窦性心律是有益的，以允许维持足够心输出量所需的适当舒张期充盈。当血液推向狭窄的二尖瓣或三尖瓣时，以及当房室(AV)同步性丧失时，产生Cannon a波。心房和心室同时收缩产生的a波发生在心动周期后期正常v波的时序。a波和v波的结合产生了大炮波。如果有室性早搏或折返性室性心动过速，也会出现炮波。
正确答案：C
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