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Discussion Starter · #1 ·
A 29-year-old woman presents to the ED with a 3-week history of being awakened by a dull, prolonged chest pain that occurs about three or four times a week. She is a smoker but has never suffered a myocardial infarction (MI) or had chest pain before and has no family history of early MI. A 12-lead ECG is normal. Her first set of cardiac enzymes (creatine kinase, creatine kinase Mb, troponin I) is negative. If coronary angiography were taken at the time of her chest pain, which would be the most likely finding in her condition?

(A) Coronary artery spasm
(B) Greater than 80% stenosis in at least two coronary arteries
(C) No findings
(D) Plaque rupture and thrombosis
 

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I think Its C ... Coz angiography will be normal in prinzmetal angina ... But it said no ECG change , In P.angina there is ST elevation .......
 

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The question is not cear whether the ecg and enzymes were done during the attack, if so then choice C is correct, otherwise the choice A is correct because in prinzmetal angina there will be ST changes, elevated cardiac enzymes and coronary spams.
 

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Discussion Starter · #6 ·
The correct answer is A

The correct answer is A
Hints to the diagnosis of Printzmetal angina is female, young, and smoker. It's caused by coronary artery spasm which should be seen during the attack (therefore choice C is incorrect).
Choice B and D are obviously incorrect because the scenario does not go with a stable angina or MI.
 
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