A 42-year-old woman presents to the urgent care clinic with recurrent chest pain and pressure radiating to her jaw. ECG is obtained and shows ST-segment elevation, but her cardiac enzymes are repeatedly found to be within normal ranges. She has a heart rate of 82/min and a blood pressure of 128/76 mm Hg. Physical examination reveals regular heart sounds with no friction rub. Which of the following options is an acceptable treatment regimen for this patient’s suspected condition?
ACalcium channel blockers and nitrates
BNitrates only
CBeta-blockers, nitrates and aspirin
DAspirin and clopidogrel
EAspirin, clopidogrel, beta-blockers, and nitrates
A 76-year-old man is admitted to the hospital for evaluation of sudden-onset chest pain. Three days after admission, he develops severe shortness of breath. Despite appropriate care, the patient dies. The heart at autopsy is shown. Which of the following most likely contributed to this patient's cause of death?
ARupture of the interventricular septum
BPseudoaneurysmal dilation of the left ventricle
CExudative inflammation of the pericardium
DOcclusion of the posterior descending artery
EBacterial infection of the mitral valve endocardium
A 58-year-old man comes to the emergency department for complaints of crushing chest pain for 4 hours. He was shoveling snow outside when the pain started. It is rated 7/10 and radiates to his left arm. An electrocardiogram (ECG) demonstrates ST-segment elevation in leads V2-4. He subsequently undergoes percutaneous coronary intervention (PCI) and is discharged with aspirin, clopidogrel, carvedilol, atorvastatin, and lisinopril. Five days later, the patient is brought to the emergency department by his wife with complaints of dizziness. He reports lightheadedness and palpitations for the past 2 hours but otherwise feels fine. His temperature is 99.7°F (37.6°C), blood pressure is 95/55 mmHg, pulse is 105/min, and respirations are 17/min. A pulmonary artery catheter is performed and demonstrates an increase in oxygen concentration at the pulmonary artery. What finding would you expect in this patient?
AWidespread ST-segment elevations
BHarsh, loud, holosystolic murmur at the lower left sternal border
CPulseless electrical activity
DDrop of systolic blood pressure by 20 mmHg during inspiration
ENormal findings
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