USMLE Forum Archives - USMLE Step 1 - 3607
3607
babbu5508 - 10-30-10 15:11
A 40-year-old man presents to his physician with complaints of chest pain. The pain is paroxysmal, substernal, and occurs while at rest. An electrocardiogram performed in the doctor's office shows ST segment elevations. Which of the following is the most likely cause of the man's pain?
Options:
A. Heartburn
B. Hypertension
C. Severe atherosclerotic narrowing of coronary arteries
D. Thromboembolism of coronary arteries
E. Vasospasm of atherosclerotic vessels
babbu5508 - 10-30-10 15:11
A 40-year-old man presents to his physician with complaints of chest pain. The pain is paroxysmal, substernal, and occurs while at rest. An electrocardiogram performed in the doctor's office shows ST segment elevations. Which of the following is the most likely cause of the man's pain?
Options:
A. Heartburn
B. Hypertension
C. Severe atherosclerotic narrowing of coronary arteries
D. Thromboembolism of coronary arteries
E. Vasospasm of atherosclerotic vessels
The correct answer and explanation will be available after you answer.
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#3
Re: 3607
babbu5508 - 01-14-11 15:30 The correct answer is E. The condition described is Prinzmetal's variant angina (paroxysmal vasospasm), which characteristically occurs at rest. It is a consequence of vasospasm of vessels that have a moderate amount of atherosclerosis. ST segment elevation indicates myocardial ischemia; the paroxysmal nature of the pain suggests vasospasm, as does the occurrence of the pain at rest. Prinzmetal's angina tends to occur in younger patients than does typical angina pectoris. Confirmation of the diagnosis rests on the angiographic detection of vasospasm, occurring spontaneously or following such provocative maneuvers as intravenous ergonovine, intracoronary acetylcholine, or hyperventilation.
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