Question 7

  7.  You are evaluating a 32 year old male who come in because of chest pain he has been experiencing exertion chest pain alleviated with rest for the last month.   He is healthy and a non smoker.  His EKG and vitals are normal.    Which of the following is the best action?

A.   Having him start taking Aspirin daily, arrange for an outpatient stress test with cardiology or internal medicine

B.  Arrange for the patient to have an immediate cardiac catheterization.

C.  Send the patient for an outpatient VQ scan

D.  Have the patient get an outpatient lipid panel and reassess the patient in 1 week.

Answer and Explanation 6

6.  The correct answer is B.  Inferior leads are II, III, and aVF.  Inferior ischemia would be represented by ST depression or T Wave inversion which is not present.  The lateral leads I, aVL, V5 and V6 show ST elevation not depression so we  no D is incorrect.  There is no evidence of a posterior wall MI on this EKG.  Clearly there is ST elevation in leads V3, V4, V5, and V6 so the diagnosis is anterior lateral myocardial infarction.

Question 6

6.  Please interpret the EKG listed below:

A.   Inferior Ischemia

B.   Anterior Lateral Infarction

C.   Posterior Wall Myocardial Infarction

D.   Lateral wall ischemia