Medical history An 81-year-old woman who presented with a 15-day history of chest discomfort, onset over two hours with continuous, squeezing, retrosternal pain, not relieved by rest and without radiation. Past medical history: coronary artery disease (CAD), arterial hypertension, dyslipidemia and ischemic stroke in 2010. On examination, HR: 120 bpm, electrocardiography (image 1) and troponin I: 0,057ng/mL (RV: 0,034ng/mL). No other comorbidities related. Electrocardiography, I, II and III leads. Question:According to the clinical history and the electrocardiographic findings presented, what is the probable diagnosis? Abbreviations: STEMI - ST-segment elevation myocardial infarction; NSTEMI - non-ST elevation myocardial infarction Type 2 MI, NSTEMI, caused by atrial fibrillation due to rapid ventricular response. Type 1 MI, STEMI, precipitated by atherosclerotic plaque disruption. Type 2 MI, NSTEMI, caused by sinus tachycardia. Unstable angina, there is not enough evidence to diagnose myocardial infarction. Test question Residência Médica 2015 (ACESSO DIRETO 1) - Sistema único de saúde - SUS - São Paulo SPQuestion:In patients with acute coronary syndrome who have increased troponin and CK-MB, presenting NSTEMI, there is no evidence of benefit in the use of: EV nitroglycerin Low molecular weight heparin Conventional heparin Antiplatlet agents Thrombolytics Time is Up! Time's up
