Progressive Care Nursing Certification (PCCN) Practice Exam

A patient with a history of IV drug abuse develops sudden dyspnea and anxiety. What is the most likely cause of these symptoms?

1. Mitral valve insufficiency

2. Ventricular aneurysm formation

3. Heart failure

4. Hemopericardium with tamponade

The correct answer is: Mitral valve insufficiency

In the scenario presented, the most plausible cause of sudden dyspnea and anxiety in a patient with a history of IV drug abuse is associated with the complications that can arise from intravenous drug use, particularly affecting the cardiovascular system. Mitral valve insufficiency can result from infective endocarditis, which is often seen in individuals with IV drug use due to the introduction of bacteria into the bloodstream. The inflammatory processes related to endocarditis can lead to damage of the heart valves, causing regurgitation, which subsequently can result in pulmonary congestion. This congestion may manifest as dyspnea, and the accompanying anxiety can arise from the distress of difficulty in breathing, as well as potential hypoxemia. While other options such as heart failure and hemopericardium with tamponade could also potentially explain dyspnea, the association with IV drug abuse leans more directly towards mitral valve insufficiency given the risk of infective endocarditis in this population. Ventricular aneurysm formation, while a potential cardiovascular issue, is less commonly acute and directly related to the immediate symptoms presented, compared with acute valve pathology that can cause rapid onset of symptoms.