A patient in their 70s presented to the emergency department (ED) with 2 hours of persistent chest pain accompanied by shortness of breath. The patient’s medical history was notable for hypertension, kidney transplantation due to bilateral kidney trauma, and long-term treatment with cyclosporine, mycophenolate mofetil, and prednisone acetate. Two months before, the patient had been hospitalized for SARS-CoV-2 infection for 1 month. Physical examination on arrival showed pulse rate of 102 beats per minute, respiratory rate of 25 breaths per minute, blood pressure of 135/78 mm Hg, and normal auscultation of the chest. The patient’s cardiac troponin I (cTnI) level was 2.62 ng/mL (reference, <0.16 ng/mL) and N-terminal pro−b-type natriuretic peptide was 1468 ng/L (reference, <125 ng/L). Findings of a 12-lead electrocardiogram (ECG) are shown in the Figure, A.
Please finish quiz first before checking answer.
Read the answer below and download your certificate.
Read the discussion below and retake the quiz.
Sign in to take quiz and track your certificates
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 Credit(s)™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
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 Authors: Jingjin Che, MD, PhD, (email@example.com) and Tong Liu, MD, PhD (firstname.lastname@example.org), Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, No. 23 Pingjiang Rd, Hexi District, Tianjin 300211, China.
Published Online: September 25, 2023. doi:10.1001/jamainternmed.2023.2461
Conflict of Interest Disclosures: None reported.
Funding/Support: This work was funded by the National Natural Science Foundation of China (No. 82170327 to T.L.) and Tianjin Key Medical Discipline (Specialty) Construction Project (No. TJYXZDXK-029A).
Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: The authors thank Ms Nan Zhang, BS, (Second Hospital of Tianjin Medical University) for helpful comments; she was not compensated.
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.
You currently have no searches saved.
You currently have no courses saved.