The Correct Answer is B!
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An 84-year-old woman presents with a lateral wall MI, treated with thrombolytic therapy. She has no prior history of coronary disease but has longstanding hypertension. Three days after her infarct, she has the sudden onset of nausea, pleuritic pain and transient hypotension, which only lasted for 15 minutes, now stable. Bedside echocardiogram reveals a small pericardial effusion.
What is the most likely diagnosis?
- Acute pericarditis
- Contained lateral wall rupture
- Vasovagal reaction
- Pulmonary embolism
Elderly women with a past history of hypertension and a first infarction are at high risk of free wall rupture, usually associated with a lateral STEMI. The acute onset of nausea and hypotension may indicate a partial rupture which is contained within the pericardium. If recognized, emergency surgery is indicated.
1. Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.
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