Cardiology Case Report: Intermittent Chest Pain

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This cardiology case report from Brady Pregerson, MD, features a patient in their late 60s presenting with multiple episodes of chest pain. Check out the ECG and determine the correct diagnosis!

History:

A patient in their late-60’s presents to the hospital with 2 hours of chest pain. Further questioning reveals he had two episodes, each lasting almost 30 minutes, with a pain-free episode in between. He says that the pain is gone, but further questioning reveals that it is 1/10 during the interview. He denies syncope, palpitations, SOB, leg swelling, fever, cough, or other complaints.

Exam:

Vital signs are normal except for a BP in the 180s. The physical exam is otherwise normal.

An ECG is done:

Printout of an ECG from a man in his 60s experiencing a STEMI. Computer Read: NSR 79, ST abnormality possible inferior and anterior subendocardial ischemia.

Computer Read: NSR 79, ST abnormality possible inferior and anterior subendocardial ischemia

What is the most likely cause of the ECG findings in this patient?


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