DIAGNOSIS OF AMI 30/12/23 - Exam (4 cases)
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9) A 40-year-old lady in ICU with acute pyelonephritis and septic shock develops chest pain. Her troponin I is elevated, and ECG shows STEMI. What type of MI has she developed?
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10) A 55-year-old man woke from sleep at night with sudden onset of central chest tightness and breathlessness. The pain radiated to the left arm, jaw and back. He was pain free on admission at midnight. His BP was 95/55 with a pulse rate of 65 bpm. Heart sounds were normal lungs were clear. ECG showed T wave inversion in the V3–V6 leads as well as II, III and aVF leads but no Q waves or ST-segment deviation. A diagnosis of ACS was made, and he was given aspirin, clopidogrel, and low-molecular-weight heparin. Troponin I on admission and after 2 hours were 0. What investigation would you order next?
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11) A 50-year-old male is admitted with AMI. Which test can differentiate ischemic but still viable myocardium from necrotic myocardium?
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12) A 65-year-old female presents with acute onset chest pain and acute ST-segment elevation myocardial infarction with 4 mm ST elevations in anteroseptal leads soon after hearing about the unexpected demise of her husband. She has a blood pressure of 90/60 mmHg, and her heart rate is 108 beats per minute. She underwent emergent cardiac catheterization showing nonobstructive coronary arteries and elevated left ventricular end-diastolic pressure of 28 mmHg. Left ventriculography shows basal hyperkinesis and apical ballooning with an estimated ejection fraction of 35%. There is no gradient across the aortic valve. What is the diagnosis?
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