09-12-2011, 03:50 PM
A 35-year-old female presents with a 1-hour history of
chest pain, which resolved spontaneously. The pain is
described as a pressure radiating to both arms. The
patient is a smoker but has a negative family history of
cardiac disease. She has no history of hypertension,
diabetes, or other significant risk factor for cardiac
disease. The patient is diaphoretic and has a normal
blood pressure. She blames the diaphoresis on the fact
that it is hot outside with high humidity and she has
just walked in from the parking lot. She looks relatively
calm and comfortable. You push on her chest
wall, and this reproduces the pain. She is now otherwise
chest-pain-free.
Which of the following is true about this
patient’s physical findings and history?
A) Pain radiating to both arms makes it unlikely that
this patient’s pain is cardiac.
B) The physical findings that are most highly associated
with cardiac disease include hypotension,
diaphoresis, and a new S3 gallop.
C) The absence of risk factors makes it unlikely that
this patient has cardiac disease.
D) The fact that the pain is reproducible on palpation
of the chest wall effectively rules out cardiac
disease.
E) None of the above.
chest pain, which resolved spontaneously. The pain is
described as a pressure radiating to both arms. The
patient is a smoker but has a negative family history of
cardiac disease. She has no history of hypertension,
diabetes, or other significant risk factor for cardiac
disease. The patient is diaphoretic and has a normal
blood pressure. She blames the diaphoresis on the fact
that it is hot outside with high humidity and she has
just walked in from the parking lot. She looks relatively
calm and comfortable. You push on her chest
wall, and this reproduces the pain. She is now otherwise
chest-pain-free.
Which of the following is true about this
patient’s physical findings and history?
A) Pain radiating to both arms makes it unlikely that
this patient’s pain is cardiac.
B) The physical findings that are most highly associated
with cardiac disease include hypotension,
diaphoresis, and a new S3 gallop.
C) The absence of risk factors makes it unlikely that
this patient has cardiac disease.
D) The fact that the pain is reproducible on palpation
of the chest wall effectively rules out cardiac
disease.
E) None of the above.