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A 78-year-old male with a 35-pack-year smoking history, hyperlipidemia, and peripheral vascular disease is at home eating dinner with his wife when he suddenly has acute onset, crushing chest pain. He lives in a remote rural area, and, by the time the paramedics arrive 30 minutes later, he is pronounced dead. What is the most likely cause of this patient's death?
Ventricular septum rupture
Chordae tendineae rupture
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A 70-year-old man presents to the emergency department with severe substernal chest pain of one hour’s duration. The patient was taking a morning walk when the onset of pain led him to seek care. His past medical history includes coronary artery disease, hyperlipidemia, and hypertension. Medications include aspirin, losartan, and atorvastatin. An electrocardiogram reveals ST elevations in the inferior leads II, III, and avF as well as in leads V5 and V6. The ST elevations found in leads V5-V6 are most indicative of pathology in which of the following areas of the heart?
Inferior wall, right coronary artery
Interventricular septum, left anterior descending coronary artery
Lateral wall of left ventricle, left circumflex coronary artery
Left atrium, left main coronary artery
Right ventricle, left main coronary artery
ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.
JAMA. 2002 Dec 18;288(23):2981-97. PMID: 12479763 (Link to Abstract)