08-04-2011, 03:56 AM
A 60-year-old male diabetic has experienced angina
on exertion for several years. A previous coronary angiog-
raphy revealed 75% stenosis of the left anterior descending
coronary artery and 50% stenosis of the right coronary
artery. His blood pressure is 110180 mm Hg. In the past
few weeks, the frequency and severity of his anginal at-
tacks have increased, and sometimes the pain occurs even
when he is lying in bed. The most likely explanation for
these changes in his symptoms is
(A) Hypertrophy of the ischemic myocardium with in-
creased oxygen demands
(B) Increasing stenosis of the right coronary artery
© Fissuring of the plaque in left coronary artery with
superimposed mural (partial) thrombosis
(D) Sudden complete thrombotic occlusion of the right
and left coronary arteries
(E) Reduction in oxygen-carrying capacity from pulmo-
nary congestion
on exertion for several years. A previous coronary angiog-
raphy revealed 75% stenosis of the left anterior descending
coronary artery and 50% stenosis of the right coronary
artery. His blood pressure is 110180 mm Hg. In the past
few weeks, the frequency and severity of his anginal at-
tacks have increased, and sometimes the pain occurs even
when he is lying in bed. The most likely explanation for
these changes in his symptoms is
(A) Hypertrophy of the ischemic myocardium with in-
creased oxygen demands
(B) Increasing stenosis of the right coronary artery
© Fissuring of the plaque in left coronary artery with
superimposed mural (partial) thrombosis
(D) Sudden complete thrombotic occlusion of the right
and left coronary arteries
(E) Reduction in oxygen-carrying capacity from pulmo-
nary congestion