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Old 04-08-2012
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EKG Chest Pain with Temporary ST Elevations!

A 50-year-old female comes to the emergency room for a first episode of chest pain irradiating to the neck and the left arm that awoke her from sleep. Her cardiac examination reveals regular heart rhythm with no murmurs or rubs. Treatment is initiated with oxygen, aspirin, and intravenous nitroglycerine, and the chest pain begins to subside. She has serial normal levels of cardiac enzymes. Her first electrocardiogram (EKG) shows ST elevation in V2 to V6, but the subsequent EKGs are normal. Which agent would be most likely to prevent further episodes?

A. Aspirin
B. Diltiazem
C. Metoprolol
D. Propranolol
E. Simvastatin

WHAT IS MOST LIKELY DX? PLEASE EXPLAIN
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Old 04-08-2012
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prinzmental angina. calcium channel blockers
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Old 04-08-2012
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isnt prinzmetals ST depression??

id go with A. Aspirin
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Old 04-08-2012
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No its calcium channel blockers, prinzmetal angina have st elevation which are tranzient
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Old 04-08-2012
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B. Diltiazem

Variant angina (and acute MI) are the usual cause of transient ST elevations. Since serial enzymes were normal, it prolly wasn't STEMI. Therefore, the best option in this case would be a calcium channel blocker (Diltiazem).
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Cardiology-, EKGs-, Internal-Medicine-, Step-2-Questions

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