Progressive Care Nursing Certification (PCCN) Practice Exam

What is the primary compensatory response of the heart to chronic aortic stenosis?

1. Left atrial dilation

2. Left ventricular hypertrophy

3. Right ventricular dysfunction

4. Left ventricular dilation

The correct answer is: Left ventricular hypertrophy

The primary compensatory response of the heart to chronic aortic stenosis is left ventricular hypertrophy. This condition occurs due to the increased workload on the left ventricle as it has to generate higher pressure to overcome the narrowed valve opening and adequately eject blood into the aorta. Over time, the left ventricular muscle thickens to accommodate this increased demand, allowing the heart to maintain cardiac output despite the obstruction. This adaptive mechanism is essential in the early stages of aortic stenosis, as it helps the heart cope with the increased hemodynamic stress. However, as the disease progresses, left ventricular hypertrophy can lead to further complications, such as decreased ventricular compliance, increased myocardial oxygen demand, and potentially heart failure. While left atrial dilation, right ventricular dysfunction, and left ventricular dilation can be associated with advanced stages of aortic stenosis, they are secondary changes. Left atrial dilation can occur due to long-standing pressure overload and consequent atrial distension. Right ventricular dysfunction may arise if there is significant left heart failure, but it is not the primary response. Left ventricular dilation might be seen later in the disease process, particularly when the hypertrophied muscle becomes unable to maintain function effectively. Therefore, left ventricular hypertrophy stands out as