All of the following may be seen as severity of mitral stenosis increases Except
Answer is C (Opening snap delayed from S2) The interval between opening snap and S2 is shoened (reduced) as severity of mitral stenosis increases. 'The opening snap generally follows the sound of Aoic valve closure (A2, S2) by 0.5 - 0.12 seconds. The time interval between S2 and OS varies inversely with the severity of MS'- Features suggesting severe M.S. Proximity of S2-OS gap Longer Duration of mid -diastolic murmur' Atrial Fibrillation may be seen in severe Mitral stenosis Mitral stenosis and mitral regurgitation are common causes of Left atrial enlargement which predisposes to AF. The probability of AF increases as severily of MS increases. The irregularly irregular pulse of AF usually means severe mitral stenosis except in elderly patients when AF can occur with mild mitral stenosis' - 'Clinical Methods in cardiology' by Raju (Orient Blackswan) 2003/201 Pulsatile liver may be seen in severe Mitral Stenosis Enlarged Pulsatile Liver is essentially a feature of Tricuspid Regurgitation. Patients with severe MS have pulmonary hypeension that may cause Tricuspid Regurgitation and result in a pulsatile liver.
Pulsatile liver
Atrial fibrillation
Opening snap delayed from S2
Length of murmur is prolonged