Question: While playing a match of tennis, a 56-year-old man with a medical history significant only for acid reflux disease starts to feel substernal chest pain that radiates into his left arm and shortness of breath. His pain feels better after drinking antacid, but since it is not completely resolved, his partner calls 911. Upon arrival, EMS administers aspirin and sublingual nitroglycerin. After 20 minutes, the man’s symptoms resolve. He is brought to the ED for further evaluation where his ECG shows sinus rhythm without any ischemic abnormalities. You order a chest radiograph and send his blood work to the laboratory for analysis. Which of the following statements regarding the diagnosis of acute MI is most accurate? A. A normal ECG rules out the diagnosis of acute MI. B. One set of negative cardiac enzymes is sufficient to exclude the diagnosis of MI in this patient. C. Troponin may not reach peak levels for at least 12 hours. D. Relief of symptoms by antacids essentially rules out a cardiac cause of his chest pain. E. Epigastric discomfort and indigestion is a rare presentation of ACS.
Posted on: Tue, 17 Sep 2013 10:38:34 +0000
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