A 68-Year-Old Man Is Brought to the Emergency Department with Chest

question 318

Multiple Choice

A 68-year-old man is brought to the emergency department with chest pain.  For the last year, the patient has had exertional chest pain that has progressively worsened.  He was shoveling snow this morning when the pain became unbearable.  He has smoked a pack of cigarettes daily for 40 years.  Blood pressure is 140/100 mm Hg and pulse is 90/min.  Examination showed mild diaphoresis.  The lungs are clear to auscultation.  ECG shows ST-and T-wave changes suggestive of ischemia.  Cardiac enzymes are elevated.  Emergent coronary angiography is performed, which demonstrates significant atherosclerotic involvement of the left anterior descending and circumflex arteries.  Development of these vascular lesions most likely involved growth factors released from which of the following sources?

• A)B lymphocytes
• B)Eosinophils
• C)Erythrocytes
• D)Mast cells
• E)Neutrophils
• F)Platelets

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