Chronic pulmonary hypertension can eventually cause which complication?

Choice A reason: Abnormally dilated arteries and veins, also known as aneurysms and varicose veins respectively, can occur due to various conditions. However, they are not the primary cause of stable angina and atherosclerosis. Aneurysms involve an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel, while varicose veins refer to enlarged, twisted veins commonly found in the legs. These conditions do not directly cause the chronic narrowing of arteries that characterize atherosclerosis and lead to stable angina.

Choice B reason: Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, usually in the legs. Although DVT is a serious medical condition that can lead to complications such as pulmonary embolism if the clot travels to the lungs, it is not related to the pathophysiology of atherosclerosis or stable angina. DVT involves venous circulation, whereas atherosclerosis and angina involve the arterial system, specifically the coronary arteries.

Choice C reason: Abnormal thickening and hardening of blood vessel walls, also known as atherosclerosis, is the primary cause of stable angina. Atherosclerosis is characterized by the buildup of plaque within the arterial walls, leading to their hardening and narrowing. This process reduces blood flow to the heart muscle, causing ischemia, which presents as chest pain, known as angina. Stable angina is a symptom of this chronic condition, which can lead to more severe cardiovascular events if left untreated.

Choice D reason: Autonomic nervous system dysfunction involves abnormalities in the autonomic nervous system, which controls involuntary bodily functions such as heart rate, blood pressure, and digestion. While autonomic dysfunction can contribute to various cardiovascular issues and symptoms such as irregular heartbeats or blood pressure changes, it is not the underlying cause of atherosclerosis or stable angina. Atherosclerosis is primarily a disease of the arterial walls, while autonomic dysfunction pertains to the regulation of bodily systems.

Choice A reason: Warfarin does not primarily prevent platelet aggregation. It is an anticoagulant that inhibits the synthesis of vitamin K-dependent clotting factors, which are necessary for blood clot formation. Although it affects the clotting process, it does not have a direct impact on platelets.

Choice B reason: Heparin does not have a longer half-life compared to warfarin. In fact, heparin has a relatively short half-life, which allows for rapid adjustments in dosing. This characteristic makes it suitable for acute management of conditions like deep vein thrombosis (DVT), where immediate anticoagulation is necessary.

Choice C reason: Heparin does not necessarily have fewer adverse effects compared to warfarin. Both medications have potential side effects and risks. Heparin can cause bleeding, heparin-induced thrombocytopenia (HIT), and other complications, while warfarin also carries a risk of bleeding and requires careful monitoring due to its interactions with foods and other medications.

Choice D reason: The onset of warfarin is slower than heparin. Heparin works rapidly to anticoagulate the blood and is often used for immediate management of conditions like DVT. Warfarin, on the other hand, takes several days to reach its full anticoagulant effect as it gradually reduces the levels of clotting factors. Therefore, patients are typically started on heparin for immediate effect and then transitioned to warfarin for long-term anticoagulation.