Chest Pain Syndromes – Post Test

A 69-year-old lady presents to the emergency department with ongoing retrosternal chest pain with radiation to both arms. Examination reveals no diagnostic features. ECG reveals ST segment depression in an anteroseptal distribution.

Which of the following statements is least appropriate?

A 70-year-old lady presents to the emergency department complaining of chest pain. Which one of the following historical factors is most likely to be associated with acute myocardial infarction (AMI)?

A 65-year-old man presents with an episode of chest pain which has lasted approximately 2 hours. He describes it as retrosternal and burning in nature. It radiated to his left arm. He is a smoker and has hypertension but is otherwise well.

Which one of the following would not increase his likelihood of having an acute myocardial infarction?

Which one of the following is least likely to be associated with hypotension?

A 67-year-old man presents with a 2-hour history of ongoing retrosternal chest pain. He has risk factors for both ischaemic heart disease and venous thromboembolism. There are no diagnostic findings on examination, ECG or CXR.

How many patients with a thoracic Aortic Dissection have widened mediastinum on CXR?

A 44-year-old woman presents with chest pain and breathlessness. She has a previous history of pregnancy related pulmonary embolism. On examination she is tachycardic, tachypnoeic and her SaO2 is 92% on air. Her blood pressure is 120/70.She has no abnormal signs on auscultation of her chest.

Which of the following investigations is going to be least useful?

Which of the following ECG abnormalities is least likely to be associated with acute myocardial infarction?

Which of the following is not a recognised risk factor for aortic dissection?

A 35-year-old man presents with atypical chest pain. He has a mild fever, tachycardia, tachypnoea and pulmonary crackles on examination. He has diffuse ST segment changes on his ECG and cardiac enlargement and interstitial oedema on his CXR.

What is the most likely diagnosis?

ST segment changes on the ECG are not normally associated with which of the following conditions?