The Daily PANCE and PANRE Question 47

A 48-year-old male presents with crushing chest pain for 45 minutes. He is diaphoretic, nauseous and short of breath. His EKG demonstrates 4 mm of ST segment depression in leads I, aVL, V5, and V6. What is the most likely diagnosis? esophageal spasm hiatal hernia acute lateral wall subendocardial myocardial ischemia acute inferior wall myocardial subendocardial ischemia acute anterior wall myocardial transmural ischemia Answer: C Acute lateral wall subendocardial myocardial ischemia It is obvious this patient is having an AMI. The ECG lead abnormalities suggest occlusion of the high lateral and low lateral walls of the LV - typically supplied by the circumflex - there are no Q waves - so subendocardial. Inferior AMI is leads II, III, avF. Anterior wall AMI is leads +- VI, with V2-V4, and maybe V5 V6. Know Your NCCPAContent Blueprint There aretwo forms of acute MI covered in theNCCPA ContentBlueprint Cardiology (16%) Non-ST-segment elevation (NSTEMI) ST segment elevation myocardial infarction(STEMI) Learn more about coronary heart disease, take an EKG rhythm strip quiz, study the cardiology flashcards or take the cardiology comprehensive exam(Smarty PANCE) (PA Life Academy) Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already, you can sign up for FREE by clicking Here. Help support The PA Life for FREE! This is provided as an opportunity for anyone who appreciates this email series to help support it painlessly. If you are going to be purchasing anything from Amazon.com (books, school supplies, etc.) simply start your next Amazon.com purchase by clicking here... it's a free way for you to help support the cause! Just click over to Amazon.com then, when you make your purchase, Amazon will send a portion of the proceeds to The Physician Assistant Life. The money goes toward paying for one-time and ongoing costs (like equipment, hosting, backup services, etc.). Thank you for supporting the site and keeping this content free! If you are studying for the PANCE or the PANRE I recommend thesereview books Stephen, Just wanted to let you know that I am enjoying your site very much and believe it is helping more than any other site Ive used thus-far (I have done HippoPA, not bad, and Brian Wallaces site). Will study some more, dont feel ready yet! Im an older PA, practiced for 18 years, have done the at home board tests the last two. I am nervous about taking the test center exam! Thanks again for your site, and the best to you! Rebecca Lynch, PA-C I PASSED! Fifth time taking the PANRE. Was totally lost on how to review. Luckily I came across your website and signed up. Did every module in both the PA Life and SmartyPANCE. Could not have passed without it! Thank you very much for your efforts on putting together such a great site. Tom Dean, PA-C The Physician Assistant  Life Academy is THE best review/practice site I have ever found.   The tests are awesome, the explanations spot on. Karol Bauman, PA-C I love your site! Im recertifying soon and your site is so incredibly helpful. Ive been a PA in a niche area for most of my career, so recertifying is always an issue. Thank goodness I found your site!! Kimberly Bastible, MS, PRA-C Dear Stephen, I wanted to thank you for your excellent website. I have been a physician assistant for 18 years and recently passed my panre again.   I was really nervous this time, as I have been working in the field of hematology oncology for the last four years. Prior to that I had worked in primary care.   Your daily questions, quizzes and websites reassurance was of tremendous help to me!   Keep up the good work. 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For the last 6 years I focused on being a mom and I chose to push the pause button on my PA career. I am thrilled to say that I passed my PANRE and this was possible because of your question style reviews and testing. This has been my favorite method to prepare for recertification. Ive taken the PANRE 3 times in the last 20 years and this time around I would not have been ready without thePAlife. Thank you for creating a great site thats affordable!! Aida Scanlon PA-C I took my PANRE and I passed! I really liked your review website. It was very helpful. I only wish I would have discovered it months ago, while preparing for the PANRE. This is my 4th time passing in my career, and I now qualify for not having to recert until 10 years from now. Thank God! but will remember your site and recommend it to others. Thanks again, Maureen Maureen Kilrain PA-C