A 50-year old man who had recently joined a gym collapsed on the treadmill. He was rushed to the hospital where the ECG shows the presence of:
**Core Concept**
The presence of a specific ECG pattern in a patient who collapsed during exercise suggests a cardiac cause for the collapse. The underlying physiological principle being tested is the relationship between cardiac electrical activity and the clinical manifestations of cardiovascular disease.
**Why the Correct Answer is Right**
The patient's ECG shows ST-segment elevation in leads V2-V3, which is consistent with an acute myocardial infarction (MI) involving the anterior wall of the left ventricle. This is supported by the patient's history of collapse during exercise, which is a common presentation of exertional angina or MI. The ST-segment elevation is due to the blockage of the left anterior descending artery (LAD), which supplies blood to the anterior wall of the left ventricle.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not relevant to the clinical scenario presented.
* **Option B:** While arrhythmias can cause collapse, the ECG pattern described does not suggest a primary arrhythmia.
* **Option C:** Hypertrophic cardiomyopathy (HCM) is a cause of sudden cardiac death in young athletes, but it typically presents with a different ECG pattern, such as left ventricular hypertrophy and ST-segment abnormalities.
**Clinical Pearl / High-Yield Fact**
A new ST-segment elevation in the anterior leads (V2-V3) in a patient with exertional symptoms is highly suggestive of an acute anterior myocardial infarction.
**Correct Answer:** C. ST-segment elevation in leads V2-V3