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USMLE · Question #503

A previously healthy 40-year-old man is brought to the emergency department because of constant substernal chest pain for 12 hours that is exacerbated by coughing and inspiration. The pain is relieved

The correct answer is D. Pericardium. See the full explanation below for the reasoning.

Question

A previously healthy 40-year-old man is brought to the emergency department because of constant substernal chest pain for 12 hours that is exacerbated by coughing and inspiration. The pain is relieved with sitting up and leaning forward. There is no family history of heart disease. His temperature is 38°C (100.4°F), pulse is 120/min, and blood pressure is 110/60 mmHg. The lungs are clear to auscultation. Cardiac examination shows distant heart sounds. An ECG shows diffuse ST-segment elevation in all leads. An x-ray of the chest shows normal findings. The most likely cause of his condition is injury to which of the following tissues?

Options

  • AAortic intima
  • BEsophageal sphincter
  • CMyocardium
  • DPericardium
  • EPleura

How the community answered

(31 responses)
  • B
    6% (2)
  • C
    6% (2)
  • D
    84% (26)
  • E
    3% (1)

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