Question:
In Rheumatic heart disease the vegetations are seen along the line of closure of the mitral valve. These vegetations are likely to get lodged in any of the following sites EXCEPT ?
In Rheumatic heart disease the vegetations are seen along the line of closure of the mitral valve. These vegetations are likely to get lodged in any of the following sites EXCEPT ?
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Mitral valve is on the left side of the heart, so its emboli go into the systemic (not pulmonary) circulation.
Updated On: Jul 8, 2026
- Brain
- Lung
- Spleen
- Kidney
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Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Step 1: Locate where the vegetations form.
In rheumatic heart disease the small vegetations sit along the line of closure of the mitral valve. The mitral valve lies between the left atrium and the left ventricle, which is the left side of the heart.
Step 2: Trace where a piece breaking off would travel.
If a small piece of vegetation breaks off (an embolus), it leaves the left ventricle, enters the aorta, and then travels wherever the aorta's branches carry it. This means it enters the systemic arterial circulation, the same blood supply that feeds the brain, spleen, kidney, limbs and other organs.
Step 3: Explain why the lung is different.
The lung receives its blood supply from the right side of the heart through the pulmonary artery, not from the left side. An embolus from a left-sided valve like the mitral valve cannot reach the lung directly, because it never enters the right heart or the pulmonary circulation. Only emboli starting on the right side of the heart (tricuspid or pulmonary valve) or arising in the systemic veins would end up in the lung.
Step 4: Confirm the organs that can be affected.
The brain, spleen and kidney are all supplied by branches of the aorta, so all three are classic sites for embolic infarcts from a mitral valve vegetation.
Final Answer:
Since mitral valve emboli travel through the systemic circulation and cannot reach the lung, the lung is the exception.
\[ \boxed{\text{Lung}} \]
In rheumatic heart disease the small vegetations sit along the line of closure of the mitral valve. The mitral valve lies between the left atrium and the left ventricle, which is the left side of the heart.
Step 2: Trace where a piece breaking off would travel.
If a small piece of vegetation breaks off (an embolus), it leaves the left ventricle, enters the aorta, and then travels wherever the aorta's branches carry it. This means it enters the systemic arterial circulation, the same blood supply that feeds the brain, spleen, kidney, limbs and other organs.
Step 3: Explain why the lung is different.
The lung receives its blood supply from the right side of the heart through the pulmonary artery, not from the left side. An embolus from a left-sided valve like the mitral valve cannot reach the lung directly, because it never enters the right heart or the pulmonary circulation. Only emboli starting on the right side of the heart (tricuspid or pulmonary valve) or arising in the systemic veins would end up in the lung.
Step 4: Confirm the organs that can be affected.
The brain, spleen and kidney are all supplied by branches of the aorta, so all three are classic sites for embolic infarcts from a mitral valve vegetation.
Final Answer:
Since mitral valve emboli travel through the systemic circulation and cannot reach the lung, the lung is the exception.
\[ \boxed{\text{Lung}} \]
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