RN Nursing · Health Assessment · Practice question
In managing a client with mitral valve stenosis, which functional deficit is most directly caused by the narrowed valve?
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Pulmonary embolism.
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Increased cardiac output.
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✓
Left atrial hypertrophy.
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Right ventricular hypertrophy.
Answer & explanation
Correct: Left atrial hypertrophy.
Mitral valve stenosis involves narrowing of the mitral valve orifice, which obstructs blood flow from the left atrium into the left ventricle during diastole. Because blood cannot empty normally from the left atrium into the ventricle, pressure builds up in the left atrium over time. This sustained pressure overload causes the left atrial walls to thicken and the chamber to enlarge, resulting in left atrial hypertrophy. This is the most direct structural consequence of the mechanical obstruction caused by the stenotic valve. Pulmonary embolism is not a direct functional consequence of the narrowed valve itself; it is a thromboembolic event that may occur as a downstream complication if atrial fibrillation develops secondary to left atrial enlargement, but it is not the most direct effect. Increased cardiac output is actually decreased, not increased, in mitral stenosis because forward flow is impeded. Right ventricular hypertrophy can occur as a later complication when elevated left atrial pressure is transmitted back through the pulmonary vasculature, causing pulmonary hypertension and subsequent right heart strain, but this is a secondary effect. Left atrial hypertrophy is the primary and most direct consequence of the obstructed outflow caused by mitral valve stenosis.
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