A client asks why he has not had major heart damage since his cardiac catheterization revealed he has 98% blockage of the right coronary artery. The nurse's best response is:
A) "You must have been taking a blood thinner for a long time."
B) "You have small channels between some of your arteries, so you can get blood from a patent artery to one severely blocked."
C) "You are just a lucky person since most people would have had a massive heart attack by now."
D) "With this amount of blockage, your red blood cells get through the vessel one-by-one and supply oxygen to the muscle."
Ans: B
Feedback:
Collateral circulation is a mechanism for the long-term regulation of local blood flow. In the heart, anastomotic channels exist between some of the smaller arteries. These channels permit perfusion of an area by more than one artery. When one artery becomes occluded, these anastomotic channels increase in size, allowing blood from a patent artery to perfuse the area supplied by the occluded vessel. For example, persons with extensive obstruction of a coronary blood vessel may rely on collateral circulation to meet the oxygen needs of the myocardial tissue normally supplied by that vessel. There is no indication that the client is on a blood thinner.
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