Pediatricsadvanced
Place the pathophysiological events of chronic mitral stenosis leading to right-sided heart failure in the correct chronological order.
Answer
Narrowing of the mitral valve orifice, Elevation of left atrial pressure, Development of secondary pulmonary hypertension, Right ventricular dysfunction and systemic venous congestion
Explanation
Mitral obstruction raises left atrial pressure; sustained pressure transmission to the pulmonary circulation can cause pulmonary hypertension and right ventricular dysfunction. **Key takeaway:** Chronic left-sided obstruction can ultimately produce right-sided failure. **Glossary:** Hepatomegaly: enlarged liver, which can occur with venous congestion.
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