Complications of pregnancy: cardiac disease: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Complications of pregnancy: cardiac disease

Sample item

A pregnant woman with mitral stenosis develops breathlessness at 28 weeks when her heart rate rises with fever. What is the mechanism of her deterioration?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Shortened diastole raises left atrial pressure

In mitral stenosis, flow across the valve depends on diastolic filling time. Tachycardia shortens diastole, so left atrial and pulmonary venous pressures rise and pulmonary oedema follows. Beta-blockers are used to slow the heart rate.

Option by option

  • A. Right-to-left shunting through the foramen ovale

    Mitral stenosis does not produce a right-to-left shunt.

  • B. Increased systemic vascular resistance in pregnancy

    Systemic vascular resistance falls in pregnancy.

  • C. Reduced afterload causes severe hypotension

    Pregnancy lowers afterload, but this is not the cause of the oedema here.

  • D. Shortened diastole raises left atrial pressure (correct)

    Correct. Tachycardia shortens the time for blood to cross the stenosed valve.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Shortened diastole raises left atrial pressure. In mitral stenosis, flow across the valve depends on diastolic filling time.

Why is "Right-to-left shunting through the foramen ovale" not the answer?

Mitral stenosis does not produce a right-to-left shunt.

Why is "Increased systemic vascular resistance in pregnancy" not the answer?

Systemic vascular resistance falls in pregnancy.

Why is "Reduced afterload causes severe hypotension" not the answer?

Pregnancy lowers afterload, but this is not the cause of the oedema here.

What concept does this question test?

It tests Complications of pregnancy: cardiac disease in OBG. Tachycardia shortens diastole, so left atrial and pulmonary venous pressures rise and pulmonary oedema follows. Beta-blockers are used to slow the heart rate.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications of pregnancy: cardiac disease?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.