Question
A case of severe mitral stenosis is associated with all of the following features, EXCEPT:
| A. |
Pulsatile liver
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| B. |
Atrial fibrillation
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| C. |
Opening snap delayed from S2
|
| D. |
Increase in the length of murmur
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Show Answer
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Correct Answer » A
Explanation
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|
Pulsatile liver is a sign of tricuspid regurgitation or severe right heart failure with elevated right atrial pressure causing hepatic vein pulsations, not directly caused by mitral stenosis.
– In severe MS, right heart failure may develop but pulsatile liver per se is not a characteristic direct finding of mitral stenosis.
– Atrial fibrillation is common due to LA enlargement and high pressure.
– The opening snap of the mitral valve is delayed as the valve orifice narrows and the LA to LV pressure gradient delays valve opening after S2.
– Murmur length increases as severity worsens because the diastolic pressure gradient between LA and LV persists for longer.
