A 60-year-old male presents to his primary care provider reporting chest pain. He is diagnosed with atherosclerosis. This disease results in:

Choice A reason: The cells of the myocardium become hypertrophic in response to increased workload or pressure, not as a result of myocardial infarction. Hypertrophy is an adaptive mechanism that can lead to impaired ventricular function over time.

Choice B reason: The resulting hypoxia leads to ischemic injury and myocardial cell death. This is the main cause of impaired ventricular function after a myocardial infarction. The loss of viable myocardial tissue reduces the contractility and pumping ability of the heart.

Choice C reason: There is a temporary alteration in electrolyte balance that can be corrected. This is not the primary cause of impaired ventricular function after a myocardial infarction. Electrolyte imbalance can occur due to fluid loss, renal impairment, or medication side effects, but it can be managed with appropriate interventions.

Choice D reason: There is too much pressure on the heart and the ventricles begin to dysfunction. This is not the direct cause of impaired ventricular function after a myocardial infarction. Increased pressure on the heart can result from hypertension, valvular disease, or pulmonary embolism, but it is not related to myocardial ischemia or necrosis.

Choice A reason: This is not the cause of pulmonary symptoms in left heart failure. Decreased cardiac output is a consequence of left heart failure, which affects the perfusion of vital organs and tissues.

Choice B reason: This is not the cause of pulmonary symptoms in left heart failure. Bronchoconstriction is a feature of asthma and chronic obstructive pulmonary disease (COPD), which affect the airways and cause wheezes and shortness of breath.

Choice C reason: This is not the cause of pulmonary symptoms in left heart failure. Inflammatory pulmonary edema is a type of non-cardiogenic pulmonary edema, which occurs when the alveolar-capillary membrane is damaged by an inflammatory process, such as pneumonia or sepsis.

Choice D reason: This is the correct cause of pulmonary symptoms in left heart failure. Pulmonary vascular congestion is a result of increased pressure in the pulmonary circulation, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes fluid to leak into the alveoli and interstitial spaces, leading to cough, dyspnea, crackles, and pink frothy sputum.