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Course: Where Is the Culprit Lesion in the New Electrocardiogram Pattern?

CME Credits: 1.00

Released: 2022-03-07

A patient in their 60s presented to the emergency department with paroxysmal chest pain. The chest pain had occurred 5 times during the day, and each episode lasted 15 to 30 minutes. On arrival, the patient’s blood pressure and pulse rate were 106/52 mm Hg and 64 beats per minutes, respectively. Chest auscultation revealed normal breath and heart sounds with no murmurs. The patient’s hemogram, serum electrolyte levels, kidney and liver function test results, and B-type natriuretic peptide and D-dimer levels were all within normal limits. Their cardiac troponin I level was 25 ng/mL (normal, <0.023 ng/mL; to convert to ?g/L, multiply by 1). The patient’s initial electrocardiogram (ECG) is shown in the , A. The patient received a diagnosis of acute non–ST-segment elevation myocardial infarction (NSTEMI). On the second day of hospitalization, the chest pain recurred. The repeated ECG taken at the onset of chest pain is shown in the , B.


Educational Objective
To identify the key insights or developments described in this article


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