Week 6
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Quiz 6 Context:
A 43-year-old man is being seen at his primary care doctor's office for routine follow up when he begins to complain of epigastric and retrosternal discomfort, dizziness, and diaphoresis. He had similar, though less severe, symptoms the previous week.
The patient's medical history is significant for poorly controlled diabetes mellitus, hyperlipidemia, and hypertension. He smokes one pack of cigarettes per day.
The physical exam reveals a heart rate of 102 bpm, blood pressure of 160/90 mmHg, respiratory rate of 24/minute. A finger-stick blood sugar is elevated. The patient appears uncomfortable. The cardiac exam reveals tachycardia. Fine rales are present in the base of the lungs. The abdominal exam is normal.
The EKG is shown below.
Sorry, that is not the most likely answer. Try Again.
d. Excellent!
This EKG reveals an ST segment elevation myocardial infarction.
You have correctly identified this week's Image of the Week. Now test your knowledge of other aspects of myocardial infarction. Do you know…
…the recommended time for the initiation of oral angiotensin converting enzyme inhibitors in a patient with myocardial infarction?
…when sub-maximal stress tests should be performed in the post- myocardial infarction patient? And when are symptom-limited stress tests recommended?
…the indications for placement of automatic implantable cardiac defibrillators (AICD) in patients post-myocardial infarction and the risk reductions associated with these devices?
The answers to these questions and a concise review of the pathogenesis, diagnosis, and treatment of acute myocardial infarction can be found in the Cleveland Clinic Foundation Disease Management Project.
This is most consistent with which of the following?
- Pericarditis
- Hyperkalemia
- Atrial Fibrillation
- Acute Myocardial Infarction
- Right Bundle Branch Block
