Pulmonary Embolism USMLE Step 1 Practice Question
A 45-year-old woman with metastatic breast cancer on active chemotherapy presents with acute dyspnea and pleuritic chest pain. Vital signs show BP 118/76, HR 108, RR 22, SpO2 88% on room air, temperature 37.2°C. She reports recent immobility. Troponin is mildly elevated at 0.08 ng/mL; BNP 450 pg/mL. CT pulmonary angiography demonstrates segmental pulmonary arterial filling defects. Leg examination reveals no edema. Which mechanism best explains the troponin elevation in this clinical context?
Answer choices
- ARight ventricular myocardial injury from acute pressure overloadCorrect answer
- BMyocardial inflammation secondary to chemotherapy cardiotoxicity
- CSkeletal muscle injury from prolonged immobility
- DLeft ventricular myocardial infarction from coronary artery occlusion
- ESepsis-induced myocardial depressant factor release
- FAcute myocardial infarction from spontaneous coronary artery dissection related to chemotherapy
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