#february2020mccqe1
A 47-year-old woman comes to the physician because she has had several episodes of severe chest pain that awoke her in the early morning. She has no history of major physical illness or drug abuse, drinks alcohol only occasionally, and does not smoke. Her temperature is 37.0 C (98.6 F), blood pressure is 126/78 mm Hg, pulse is 78/min and regular, and respirations are 12/min. An ECG reveals no abnormalities. No further studies are undertaken, and the physician tells the patient that her pain is probably of psychological origin. After a few days, the patient comes to the emergency department at 5 AM complaining of chest pain. An ECG reveals sinus rhythm with ST segment elevation. The patient is admitted, and coronary arteriography is performed, revealing no stenotic lesions. Intravenous administration of ergonovine during arteriography triggers chest pain accompanied by ST elevation on ECG. Which of the following is the most likely diagnosis?
(A) Myocardial infarction
(B) Prinzmetal angina
(C) Psychological chest pain
(D) Stable angina
(E) Unstable angina
A 47-year-old woman comes to the physician because she has had several episodes of severe chest pain that awoke her in the early morning. She has no history of major physical illness or drug abuse, drinks alcohol only occasionally, and does not smoke. Her temperature is 37.0 C (98.6 F), blood pressure is 126/78 mm Hg, pulse is 78/min and regular, and respirations are 12/min. An ECG reveals no abnormalities. No further studies are undertaken, and the physician tells the patient that her pain is probably of psychological origin. After a few days, the patient comes to the emergency department at 5 AM complaining of chest pain. An ECG reveals sinus rhythm with ST segment elevation. The patient is admitted, and coronary arteriography is performed, revealing no stenotic lesions. Intravenous administration of ergonovine during arteriography triggers chest pain accompanied by ST elevation on ECG. Which of the following is the most likely diagnosis?
(A) Myocardial infarction
(B) Prinzmetal angina
(C) Psychological chest pain
(D) Stable angina
(E) Unstable angina
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