The correct answer is C. This patient’s symptoms suggest that he is experiencing nitroglycerine withdrawal. Nitroglycerine is a vasodilator. Chronic industrial exposure leads to tolerance for vasodilatation on work days and a compensatory vasoconstriction on weekends when the exposure is removed, thus resulting in the “Monday disease.” The most severe consequence is when the compensatory vasoconstriction is un- opposed in critical areas such as the coronary vessels, leading to non-atherosclerotic-related ischemia.
Answer A is incorrect. Anemia can be a result of lead or other heavy metal poisoning, but not nitroglycerine.
Answer B is incorrect. Atherosclerosis is formed by fatty streak deposition, which along with endothelial damage results in plaque formation over time. It is not linked to nitroglycerine exposure.
Answer D is incorrect. Congestive heart failure can be a complication of long-term coronary artery disease or a myocardial infarction, but not of nitroglycerine exposure.
Answer E is incorrect. Dementia can be a result of neurotoxin exposures (eg., mercury). Nitroglycerine exposure does not cause dementia.