The nurse is assessing a client with a diagnosis of mitral stenosis. Which piece of assessment data indicates that the disease is worsening?

A. Dyspnea on exertion indicates worsening mitral stenosis due to increased left atrial pressure and pulmonary congestion. B. Epigastric pain is not a typical symptom of mitral stenosis progression. C. Jugular vein distention and peripheral edema suggest right-sided heart failure, which may occur later but not the earliest sign. D. An increase in systolic blood pressure is not directly related to mitral stenosis worsening.