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Week 8

 

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Quiz 8 Context:

A 25-year-old man presents with the complaint of severe chest, shoulder, and back pain. The patient was recently seen by his primary care doctor for myalgias and pharyngitis. At that time, he was treated symptomatically. Over the past 12 hours he reports the developement of chest, shoulder, and back pain. The pain is worse with deep breathing. The patient also complains of fevers and diaphoresis.

The patient's medical history is significant for hidradenitis suppurativa and inguinal hernia.

The physical exam reveals a heart rate of 90 bpm, blood pressure of 144/60 mmHg, respiratory rate of 26/minute. The patient is in obvious discomfort. The cardiac exam reveals a regular rate and rhythm. A high pitched rub is audible over the left lower sternal border. The lungs are clear to auscultation. The remainder of the exam is unremarkable.

An EKG is obtained.

The EKG is shown above.

This is most consistent with which of the following?

  1. Acute Myocardial Infarction
  2. Pericarditis, Stage 4
  3. Wolff-Parkinson-White Pattern
  4. Electrical alternans Myocardial Infarction
  5. Pericarditis, Stage 1

 

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Copyright © 2000-2011 The Cleveland Clinic Foundation. All Rights Reserved.
Center for Continuing Education | 9500 Euclid Avenue, KK31, Cleveland, OH 44195