A 54-year-old man comes to the office due to episodic burning substernal chest pain. His pain increases with activity and improves with rest. The patient has a history of hypertension and hyperlipidemia. He has smoked a pack of cigarettes daily for the past 30 years. His blood pressure is 140/85 mm Hg and pulse is 76/min. Cardiac auscultation reveals a S4 heart sound. Lung and abdominal examinations are unremarkable. An ECG at rest shows left ventricular hypertrophy. A myocardial perfusion scan reveals inducible ischemia of the inferior surface of the heart. Which of the following coronary arteries is most likely occluded in this patient?

Question

A 54-year-old man comes to the office due to episodic burning substernal chest pain.  His pain increases with activity and improves with rest.  The patient has a history of hypertension and hyperlipidemia.  He has smoked a pack of cigarettes daily for the past 30 years.  His blood pressure is 140/85 mm Hg and pulse is 76/min.  Cardiac auscultation reveals a S4 heart sound.  Lung and abdominal examinations are unremarkable.  An ECG at rest shows left ventricular hypertrophy.  A myocardial perfusion scan reveals inducible ischemia of the inferior surface of the heart.  Which of the following coronary arteries is most likely occluded in this patient?

Quizplus · Accepted Answer

The Answer is D

A 54-Year-Old Man Comes to the Office Due to Episodic