DIAGNOSIS OF AMI 29/12/23 - Exam (4 cases)

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5) A 50-year-old female has presented with chest pain of 3 hours duration. You believe that she is having an acute myocardial infarction. Which feature would not be true for an MI?

1 point

a. ST-elevation seen in all leads

b. Chest-pressure radiating to right arm

c. Dyspnea

d. Nausea and diaphoresis

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6) A 65-year-old male has come with typical ischemic chest pain. His vitals are normal. ECG shows ST elevation. What will you do next?

1 point

a. Get troponin level

b. Repeat ECG

c. Urgent echo

d. Prompt reperfusion

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7) A 60-year-old male is admitted with myocardial infarction. What is the best investigation for identifying the extent of acute myocardial ischemia?

1 point

a. Coronary angiography

b. ECG

c. Estimating troponin every hour

d. Estimating CPK - MB every hour

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8) A 67-year-old patient with atrial fibrillation and mild congestive heart failure has an episode of minor chest discomfort overnight. He has become slightly more breathless than usual but is not seriously distressed. ECG shows AF. Troponin T about 12 hours after the pain is 52ng/L (Normal troponin T = 0 - 0.01 ng/mL). The patient is kept overnight and a further specimen at 24 hours is again 52ng/L. A repeat ECG does not show any change. What would you do?

1 point

a. Discharge the patient

b. Arrange for angiography

c. Arrange for echo

d. Do troponin I

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