A 64-Year-Old Man Comes to the Emergency Department Due to Substernal

question 55

Multiple Choice

A 64-year-old man comes to the emergency department due to substernal chest pressure for the last 2 hours and associated mild nausea.  Two weeks ago, he underwent right coronary artery stenting for stable angina.  He also has hypertension and hyperlipidemia.  His blood pressure is 92/60 mm Hg and pulse is 48/min.  He is diaphoretic, and his extremities are cold.  Lungs are clear on auscultation.  There are no heart murmurs.  ECG shows sinus bradycardia with 2-mm ST-segment elevation in leads II, III, and aVF.  Which of the following additional history is most helpful in diagnosing the cause of this patient's condition?

• A)Alcohol abuse
• B)Dietary habits
• C)High-intensity exercise
• D)Illicit drug use
• E)Medication compliance

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Definitions:

Cognitive-Behavioral

Relating to a psychotherapeutic approach that addresses dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systematic process.

Premature Ejaculation

A sexual dysfunction characterized by ejaculation that occurs with minimal sexual stimulation before, upon, or shortly after penetration and before the person wishes it.

Erectile Difficulties

A condition characterized by the inability to develop or maintain an erection of the penis during sexual activity.

Vaginismus

A condition involving involuntary muscle spasm in the pelvic floor that interferes with sexual intercourse or any attempt at vaginal insertion.