Coronary Artery Disease USMLE Step 1 Practice Question
A 62-year-old man with hypertension and hypercholesterolemia presents with substernal chest pressure that develops after climbing two flights of stairs and resolves with rest within 5 minutes. Vital signs: BP 158/92 mmHg, HR 94 bpm, RR 16, SpO2 98% on room air. Temperature is normal. Recent lipid panel shows LDL 180 mg/dL. Cardiac examination reveals no murmurs. Which of the following is the most likely cause of his symptoms?
Answer choices
- AFixed atherosclerotic narrowing causing demand ischemiaCorrect answer
- BTransient coronary vasospasm at rest
- CInflammation of the pericardial sac
- DRupture of an unstable plaque with thrombotic occlusion
- EAcute pulmonary arterial obstruction
- FSpontaneous coronary artery dissection with intermittent flow limitation
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