A patient is diagnosed with chronic obstructive pulmonary disease (COPD) and has elevated pulmonary vascular resistance. Which complications would the health care professional assess the patient for?
Left heart failure
Restrictive cardiomyopathy
Hypertrophic cardiomyopathy
Right heart failure
The Correct Answer is D
A. Left heart failure: COPD primarily affects the lungs and increases pulmonary vascular resistance, leading to right-sided heart strain rather than left heart failure. Left heart failure is more commonly associated with conditions such as hypertension, myocardial infarction, and valvular diseases, which impair the heart’s ability to pump blood systemically.
B. Restrictive cardiomyopathy: Restrictive cardiomyopathy is a condition where the heart muscle becomes stiff and loses its ability to relax and fill properly, often due to infiltrative diseases such as amyloidosis or sarcoidosis. COPD does not directly lead to restrictive cardiomyopathy, as its primary cardiovascular complication is increased pulmonary resistance causing right heart strain.
C. Hypertrophic cardiomyopathy: Hypertrophic cardiomyopathy is characterized by abnormal thickening of the heart muscle, usually due to genetic mutations. It primarily affects the left ventricle and impairs diastolic filling. COPD does not cause hypertrophic cardiomyopathy, as its cardiovascular effects are due to pulmonary hypertension and right ventricular overload rather than structural abnormalities of the myocardium.
D. Right heart failure: Chronic COPD leads to persistent pulmonary hypertension due to hypoxic vasoconstriction and remodeling of pulmonary vessels. This increased pulmonary vascular resistance forces the right ventricle to work harder to pump blood into the lungs, leading to right ventricular hypertrophy and eventual right heart failure, also known as cor pulmonale. Symptoms include peripheral edema, jugular vein distention, and hepatomegaly due to systemic venous congestion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Cardiac failure: While cardiac failure can lead to changes in heart function, it does not directly cause an acquired murmur. Murmurs are typically due to valvular or structural abnormalities rather than being a direct consequence of heart failure.
B. Coronary artery disease (CAD): CAD can lead to ischemic heart disease and may contribute to heart failure but is not typically associated with the development of an acquired murmur. It does not directly create new murmurs; rather, it can exacerbate existing heart conditions.
C. Congenital malformation: Congenital malformations are structural heart defects present at birth and are classified as congenital causes of murmurs rather than acquired. These murmurs result from anatomical abnormalities rather than changes occurring after birth.
D. Rheumatic fever: Rheumatic fever is an acquired condition that can cause damage to the heart valves, leading to the development of valvular insufficiency or stenosis. These changes can produce an acquired murmur as a result of the inflammation and scarring of the heart valves following the infection.
Correct Answer is B
Explanation
A. Septal: Septal cardiomyopathy typically refers to abnormalities in the interventricular septum and does not specifically address the rigidity and noncompliance of the myocardium that affects diastolic filling.
B. Restrictive: Restrictive cardiomyopathy is characterized by a rigid and noncompliant myocardium that impedes ventricular filling during diastole. This results in elevated pressures in the ventricles and may lead to heart failure symptoms due to poor filling capacity.
C. Infiltrative: Infiltrative cardiomyopathy involves the deposition of abnormal substances (such as amyloid or sarcoid) within the myocardial tissue, which can lead to stiffness. While this may contribute to restrictive physiology, "restrictive" is the more precise term for the condition described.
D. Hypertrophic: Hypertrophic cardiomyopathy is characterized by an abnormal thickening of the heart muscle, particularly the left ventricle. While this condition can affect diastolic filling, it is primarily due to muscle hypertrophy rather than rigidity and noncompliance of the myocardium.
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