A 30-year-old woman with a history of mitral valve problems states that she has been "very tired." She has started waking up at night and feels like her "heart is pounding." During the assessment, the nurse palpates a thrill and forceful pushing of the ventricle at the fifth left intercostal space MCL.In the same area, the nurse also auscultates a blowing, swishing sound right after S₁.These findings would be most consistent with:

Question

Quizplus · Accepted Answer

These findings are consistent with mitral regurgitation.Subjective findings include fatigue, palpitation, and orthopnea, and objective findings are (1) a thrill in systole at the apex; (2) a lift (heave or forceful pushing of the ventricle) at the apex; (3) the apical impulse displaced down and to the left; (4) S₁ is diminished, S₂ is accentuated, and S₃ at the apex is often present; and (5) a pansystolic murmur that is often loud, blowing, best heard at the apex, and radiating well to the left axilla.

A 30-Year-Old Woman with a History of Mitral Valve Problems