Question

The patient with diabetes and shortness of breath is brought from the nursing home to the hospital emergency department. The electrocardiogram (ECG) shows evidence of a myocardial infarction (MI), but the patient denied ever having chest pain. Which is the best explanation of what happened?

A. The patient had a "silent" MI related to autonomic neuropathy.
B. The patient had chest pain but forgot because of dementia.
C. The patient minimized the chest pain because he was worried about costs.
D. The patient has the psychologic defense mechanism of denial.

Answer 1

The best explanation is that the patient had a "silent" MI related to autonomic neuropathy.

Step-by-step explanation:

The best explanation for the patient with diabetes and shortness of breath who is brought to the hospital emergency department and shows evidence of a myocardial infarction (MI) on the electrocardiogram (ECG) despite denying chest pain is option A: The patient had a "silent" MI related to autonomic neuropathy.

Silent MIs occur when a person experiences an MI without the typical chest pain or other symptoms. Autonomic neuropathy, a complication of diabetes, can affect the nerves that control sensations such as pain, leading to a lack of awareness of chest pain. This can make it difficult for patients with diabetes to recognize they are having an MI. Therefore, it is possible for someone to have an MI without experiencing chest pain, even though they have evidence of it on the ECG.