A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting.
Which cause of the patient's symptoms would the nurse suspect?

Spasm of a major coronary artery.

Exposure of the thrombogenic surface to plaque.

Myocardial ischemia due to coronary artery disease.

Myocardial ischemia secondary to microvascular disease.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Spasm of a major coronary artery, also known as variant (Prinzmetal's) angina, typically occurs at rest and is not necessarily provoked by exertion. The patient's chest pain is exacerbated by exertion, making this choice less likely.

Choice B rationale:

Exposure of the thrombogenic surface to plaque refers to acute coronary syndromes like unstable angina or myocardial infarction. While plaque rupture and thrombosis can cause myocardial ischemia, the characteristic feature of these conditions is chest pain that may not be relieved by rest, unlike the patient described here.

Choice D rationale:

Myocardial ischemia secondary to microvascular disease, also known as cardiac syndrome X, is a condition where chest pain occurs without significant coronary artery stenosis. However, this condition usually affects women, and the pain is often unrelated to exertion. In the given case, the pain is provoked by exertion, making this choice less likely.

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Correct Answer is C

Explanation

Choice A rationale:

Silent ischemia refers to a lack of oxygen to the heart that doesn't cause symptoms like chest pain. It is often diagnosed during an electrocardiogram (ECG) done for other reasons. The patient in this scenario is experiencing chest pain, so silent ischemia is not the correct choice.

Choice B rationale:

Angina decubitus refers to chest pain that occurs while lying down and is relieved by standing or sitting. The patient in this scenario is experiencing chest pain at rest, which is not characteristic of angina decubitus.

Choice D rationale:

Chronic stable angina is chest pain or discomfort that typically occurs with activity or stress and is relieved by rest or nitroglycerin. The patient in this scenario is experiencing chest pain at rest, which is not characteristic of chronic stable angina.

A. Serotonin. B. Platelet factor III. C. Von Willebrand factor. D. Adenosine diphosphate.

Correct Answer is C

Explanation

Choice A rationale:

Serotonin is a neurotransmitter that plays a role in mood regulation, sleep, and other functions in the body. It is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process.

Choice B rationale:

Platelet factor III is not a component that forms an adhesive bridge between platelets and vascular subendothelial structures in the clotting process. Platelet factor III is not widely recognized in the context of clotting; it is more commonly referred to as tissue factor and is involved in the extrinsic pathway of coagulation.

Choice C rationale:

Von Willebrand factor (VWF) is a protein that plays a crucial role in hemostasis. It forms an adhesive bridge between platelets and vascular subendothelial structures, particularly at sites of vascular injury. VWF helps platelets adhere to the injured vessel wall, leading to the formation of a stable blood clot. This process is essential for preventing excessive bleeding. A deficiency or dysfunction in VWF can lead to von Willebrand disease, a bleeding disorder characterized by prolonged bleeding times.

Choice D rationale:

Adenosine diphosphate (ADP) is a molecule released by platelets when they are activated. ADP helps in the aggregation of platelets, but it does not directly form an adhesive bridge between platelets and vascular subendothelial structures.

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A patient reports episodic chest pain lasting a few minutes that is provoked by exertion and relieved within 10 minutes upon resting.
Which cause of the patient's symptoms would the nurse suspect?