07-21-2006, 06:55 PM
44-year-old woman presents with a chief complaint of a sharp,
stabbing pain in her chest for the past 12 hours. A careful history
reveals that the patient experienced a myocardial infarct 3 years
ago. The woman refuses to lie down in the examining room and
instead leans forward, stating that it allows her to breathe
more easily. Physical examination is unremarkable. The ECG
demonstrates diffuse ST segment elevations with upright T waves.
Chest radiographs appear normal. Creatine kinase (MB fraction)
is normal. Which of the following is the most likely diagnosis?
A. Acute pericarditis
B. Dissecting aortic aneurysm
C. Myocardial infarction
D. Stable angina
E. Unstable angina
stabbing pain in her chest for the past 12 hours. A careful history
reveals that the patient experienced a myocardial infarct 3 years
ago. The woman refuses to lie down in the examining room and
instead leans forward, stating that it allows her to breathe
more easily. Physical examination is unremarkable. The ECG
demonstrates diffuse ST segment elevations with upright T waves.
Chest radiographs appear normal. Creatine kinase (MB fraction)
is normal. Which of the following is the most likely diagnosis?
A. Acute pericarditis
B. Dissecting aortic aneurysm
C. Myocardial infarction
D. Stable angina
E. Unstable angina