A patient in their 40s with no history of cardiovascular disease presented to the emergency department with a constant, substernal chest pain accompanied by sweating, which had started one and a half hours prior.
On arrival, the patient’s vital signs were as follows: blood pressure, 158/77 mm Hg; pulse, 78 beats/min; temperature, 36.0 °C; respiratory rate, 16 breaths/min; and oxygen saturation was 95% on room air. The patient was hemodynamically stable, and physical examination findings were unremarkable. Results of blood chemistry tests and complete blood cell count were within normal limits. The result of an initial troponin I test was normal. An electrocardiogram (ECG) was obtained (Figure, A). Forty minutes later, a preoperative ECG was performed (Figure, B).
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Yongxia Wu, MD, Division of Cardiology, Beijing Luhe Hospital, Capital Medical University, Tongzhou District, Beijing 101149, China (firstname.lastname@example.org).
Published Online: June 20, 2023. doi:10.1001/jamainternmed.2023.1558
Conflict of Interest Disclosures: None reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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