Audio Qbank – Q239 – A 46F with chest pain

 

A 46-year-old woman comes to the physician because of a 24-hour history of sharp chest pain exacerbated by deep breathing. She walks into the room bent over at the waist. Her current medications include naproxen and prednisone prescribed to her by a rheumatologist. BP is 120/80 when sitting. This decreases to 112/76 during inhalation. An x-ray of her hands is shown.

Which of the following is most likely to be seen on electrocardiogram in this patient?

Electrical alternans
Irregularly irregular R-R intervals
No abnormalities
ST-segment elevations (II, III, aVF)
ST-segment elevations (diffuse)