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In the context of congestive heart failure (CHF), observing decreased preload of the right heart is least likely because, generally, CHF is associated with volume overload rather than volume depletion. When the heart is failing, especially in cases such as left-sided heart failure, the effect often leads to congestion and fluid accumulation in the venous system, which results in increased preload.

As the heart struggles to pump effectively, the body compensates by retaining fluid, leading to increased filling pressures and volumes in the right heart. Orthopnea occurs when the patient has difficulty breathing while lying flat, directly related to pulmonary congestion, common in CHF. Stenosis of the mitral valve can contribute to left-sided heart failure and its associated symptoms, as it impedes blood flow, leading to increased pressures in the heart and lungs. Pulmonary edema, a hallmark sign of CHF, results from fluid buildup in the lungs due to congestive effects, particularly from left-sided heart failure. All these findings are characteristic or directly linked with the pathophysiology of CHF, while decreased preload is typically not observed in this condition.