doc4mindia
Forum Guru
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A 54-year-old man is admitted to the hospital because of a 30-minute history of substernal chest pain, difficulty breathing, and vomiting. His electrocardiogram on admission showed ST elevation in leads V4-V6, ST depression and inverted T waves in leads II, III, and aVF. Two hours later an electrocardiogram shows Q waves and laboratory studies show elevated troponin levels. His records indicate that he was treated with nitroglycerin, morphine, atenolol, oxygen, heparin, and aspirin. He tells you that he had a 5-minute "mini-stroke" 3 weeks before this incident, but he does not have any residual abnormalities. Today, he is complaining of sharp chest pain that increases when he is in the supine position. His temperature is 38.3 C (101.0 F), blood pressure is 110/70 mm Hg, and pulse is 85/min. An electrocardiogram shows ST elevations in leads V1-V6 and II, III, and aVF with diffuse PR interval depression. At this time the diagnosis is most likely to be
a. acute pericarditis
b. cardiac tamponade
c. pulmonary embolism
d. recurrent ischemia
e. rupture of the intraventricular septum
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| prep4usmle
Administrator
Topics: 288
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This looks like pericarditis but I do not understand well the time table: are all of these symptoms, labs & ECG changes happen on the same day?
Regards
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| dimps
Forum Guru
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a acute pericarditis
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hi how r u
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