A 68-year-woman presents to the emergency department complaining of chest pain for the past 30 minutes. The pain is retrosternal in location and it radiates to her neck. She has no history of cardiac conditions or similar episodes of chest discomfort, and her past medical history includes hypertension and dyslipidemia.On physical examination, she is diaphoretic and in moderate distress. The blood pressure is 150/90 mm Hg, the heart sounds are normal, and the lungs clear on auscultation. The ECG is shown in Figure below. Which of the following mechanisms is the most likely cause of her condition?
Correct Answer: coronary plaque rupture
Description: Acute rupture of an atherosclerotic plaque is now recognized as the most common cause of ST-elevation MI. Pericarditis has diffuse ST elevation in multiple leads and aortic stenosis does cause angina but not ST elevation on the ECG. Vasculitis is a very rare and unusual cause of coronary ischemia and therefore unlikely. Myocarditis does not cause ST-segment elevation.
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