A 35-year-old woman is being evaluated for regular health check. During the last 6 months, she has felt dyspnea especially after walking only 3-4 blocks on level ground. She also has an occasional dry cough at night. She has no other symptoms of pain, palpitations or weight loss. On physical examination, the patient appears comfortable. Blood pressure is 122/70 mm Hg and pulse is 75/min and regular. On cardiac auscultation S1 is loud and a diastolic murmur is heard at mid- and end diastole with the patient positioned on her left side and breath held at the end of expiration. Otherwise, examination is unremarkable. Which of the following are the most likely left ventricular hemodynamic findings at rest in this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Mitral stenosis usually occurs due to underlying rheumatic heart disease and initially presents with exertional dyspnea. Orthopnea, paroxysmal nocturnal dyspnea, productive cough, and hemoptysis can develop as the disease becomes more advanced. At rest, left ventricular diastolic pressure, afterload, and contractility remain normal until the mitral stenosis is severe.

A 35-Year-Old Woman Is Being Evaluated for Regular Health Check