A 34-Year-Old Man with History of Type 1 Diabetes Mellitus

question 68

Multiple Choice

A 34-year-old man with history of type 1 diabetes mellitus comes to the emergency department because of retrosternal chest pain for the past 12 hours.  His symptoms started last night and woke him up several times because he could not find a comfortable position.  He also describes pain in his left shoulder on deep inspiration.  His father died of a heart attack at the age of 46.  He quit smoking 8 years ago.
His temperature is 37.8 C (100.2 F) , blood pressure is 110/70 mm Hg, and pulse is 100/min.  No murmurs are heard on cardiac auscultation.  Fine crackles are heard at the left lung base that clear with coughing.  An ECG is obtained and shown in this exhibit.
Which of the following changes would be expected on repeat ECG one week later?

• A)Diffuse T wave inversion
• B)First degree atrioventricular block
• C)Left axis deviation
• D)Pathologic Q waves in precordial leads
• E)ST segment depression in anterolateral leads

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