A 50-year-old man had chest pain radiating to the shoulder, neck and jaw 3 days ago. Troponin is high; ECG unremarkable. What is the diagnosis?
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الإجابة: C. NSTEMI
Ischaemic chest pain with raised troponin but no ST elevation = NSTEMI. Troponin stays elevated for up to ~2 weeks, so it is still high 3 days after the pain. Unstable angina has negative troponin; STEMI requires ST elevation; stable angina is exertional pain without infarction.
ليش كل خيار صح أو غلط
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A
ليش غلط
Unstable angina has no detectable troponin elevation, whereas this patient has a high troponin (STEMI/NSTEMI: elevation above the 99th percentile).
✓ CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 9 -
B
ليش غلط
STEMI needs ST elevation on ECG; in unstable angina and NSTEMI there will not be ST elevations, and this ECG is unremarkable.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 11 -
C
ليش صح
NSTEMI is separated from unstable angina by positive troponins and from STEMI by the absence of ST elevation, matching raised troponin with an unremarkable ECG.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 11 -
D
ليش غلط
Stable angina is not an ACS: it occurs with a consistent level of exertion and is relieved by rest or nitroglycerin. A raised troponin means infarction.
✓ Step-Up To Medicine 6th (IHD & ACS).pdf · p. 11
- المصدر
- Step-Up To Medicine 6th (IHD & ACS).pdf · p. 11
CARDIOLOGY- ISCHEMIC HEART DISEASES (IHDs).pdf · p. 9 - المحاضرة
- Acute Coronary Syndrome · Cardiology · Module B
- ظهر في
- MED41 ♀ EOM B