#oldrecallmccqe1
A 39-year-old man presents to the emergency department with acute onset of shortness of breath, hemoptysis, and left-sided pleuritic chest pain. His past medical history includes medication-controlled asthma, peptic ulcer disease, and a recent onset of idiopathic nephrotic syndrome. His blood pressure is 180/100 mm Hg, pulse is 110/min, and respirations are 28/min. Cardiac and lung examinations are normal. Laboratory data are remarkable for a serum lactate dehydrogenase of 300 U/L. An ECG shows sinus tachycardia, prominent S waves in lead 1, inversions of the T wave, and a prominent Q wave in lead III. Which of the following is the most likely cause of the chest pain?
(A) Aortic dissection
(B) Esophageal spasm
(C) Myocardial infarction
(D) Pneumonia
(E) Pulmonary embolism
(F) Variant angina
A 39-year-old man presents to the emergency department with acute onset of shortness of breath, hemoptysis, and left-sided pleuritic chest pain. His past medical history includes medication-controlled asthma, peptic ulcer disease, and a recent onset of idiopathic nephrotic syndrome. His blood pressure is 180/100 mm Hg, pulse is 110/min, and respirations are 28/min. Cardiac and lung examinations are normal. Laboratory data are remarkable for a serum lactate dehydrogenase of 300 U/L. An ECG shows sinus tachycardia, prominent S waves in lead 1, inversions of the T wave, and a prominent Q wave in lead III. Which of the following is the most likely cause of the chest pain?
(A) Aortic dissection
(B) Esophageal spasm
(C) Myocardial infarction
(D) Pneumonia
(E) Pulmonary embolism
(F) Variant angina
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