Which of the following diagnostic/assessment findings would been seen in a client with worsening mitral valve stenosis? Select all that apply
A) Low-pitched diastolic murmur that is increasing in duration
B) Sharp elevation in left atrial pressure
C) Decreased cardiac output
D) Severe elevation in left ventricular end-diastolic pressure
E) Left ventricle increases its stroke volume
Ans: A, B, C
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The increased left atrial pressure eventually is transmitted to the pulmonary venous system, causing pulmonary congestion. A characteristic auscultatory finding in mitral stenosis is an opening snap following the second heart sound, which is caused by the stiff mitral valve. As the stenosis worsens, there is a localized low-pitched diastolic murmur that increases in duration with the severity of the stenosis. Manifestations are related to the elevation in left atrial pressure and pulmonary congestion such as dyspnea with exertion, decreased cardiac output owing to impaired left ventricular filling, and left atrial enlargement with the development of atrial arrhythmias and mural thrombi. Severe elevation in left ventricular end-diastolic pressure and left ventricle increases its stroke volume occur with aortic regurgitation.
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