A 39-year-old client has been admitted to the hospital with complaints of increasing fatigue.The history is remarkable for rheumatic fever as a child.The nurse hears a diastolic murmur at the apex when the client is in the left lateral position.The murmur is described as a rumble without radiation.This description is most consistent with:

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The diastolic murmur heard at the apex with a rumble without radiation is most consistent with mitral stenosis, which is caused by narrowing of the mitral valve. Rheumatic fever, which the client had as a child, is a common cause of mitral stenosis. Tricuspid regurgitation and pulmonary stenosis would typically present with systolic murmurs, while mitral regurgitation would present with a holosystolic murmur.

A 39-Year-Old Client Has Been Admitted to the Hospital with Complaints