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A 56-Year-Old Woman Comes to the Emergency Department with a Two-Day

question 31

Multiple Choice

A 56-year-old woman comes to the emergency department with a two-day history of substernal chest pain and mild shortness of breath. She takes levothyroxine for hypothyroidism and alendronate for osteoporosis. She has been under a great deal of stress at her job lately because many of her co-workers were recently terminated. Her mother died from a stroke at the age of 65 and her father had a heart attack at the age of 67. She smokes a half-pack of cigarettes per day and drinks alcohol socially. She denies any illicit drug abuse.
Her blood pressure is 122/70 mm Hg and pulse is 100/min and regular. Her oxygen saturation is 98% on room air. Lungs are clear on auscultation.
An EKG shows deep T wave inversions in the anterior precordial leads. Her troponin I level is 2.2 ng/ml (normal < 0.012) .
The patient is taken to cardiac catheterization, which shows no evidence of coronary artery disease. On left ventriculogram, the apex is non-contractile while the base is hypercontractile.
Which of the following is the most likely prognosis for this patient?

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