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Review Question - QID 214420

Angina Introduction Types of Angina Types Pathology Clinical Presentation Comments Stable angina  Typically secondary to atherosclerosis this impairs coronary perfusion in the setting of increased cardiac demand (e.g., exertion) Chest pain that develops QID: 214420 (M2.OMB.4774)
In scope icon M 6 A
QID 214420 (Type "214420" in App Search)
A 67-year-old man presents to the emergency department with chest pain. He has had chest pain for the past year that occurs whenever he gets up to get his mail. It goes away when he sits down for 5 minutes. Currently, he is pain-free. The type of chest pain he experiences is not different during these episodes; however, he has been unable to follow up with a primary doctor during this time frame and wants his pain to be checked out. His temperature is 99.0°F (37.2°C), blood pressure is 144/84 mmHg, pulse is 133/min, respirations are 14/min, and oxygen saturation is 95% on room air. Physical exam is notable for an obese man in no acute distress. Cardiopulmonary exam is unremarkable. An ECG is performed as seen in Figure A which is similar to an ECG performed last year. Initial laboratory values are ordered as seen below.

Hemoglobin: 14 g/dL
Hematocrit: 45%
Leukocyte count: 4,900/mm^3 with normal differential
Platelet count: 191,000/mm^3
Troponin: < 0.01 ng/mL

Which of the following is the most likely diagnosis?
  • A
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  • A