Question

A 42-year-old woman presents to the emergency department with complaints of fatigue, shortness of breath, back pain and nausea. A 12-lead ECG is obtained and shows ST-segment depression in leads II, III, and aVF and intermittent runs of nonsustained ventricular tachycardia. Cardiac serum markers are elevated. These findings suggest which condition?

High-risk non-ST-segment elevation ACS (NSTE-ACS)
Low-risk non-ST-segment elevation ACS (NSTE-ACS)
Intermittent-risk non-ST-segment elevation ACS (NSTE-ACS)
ST-segment elevation myocardial infarction (STEMI)

Answer 1

A 42-year-old woman with ST-segment depression, elevated cardiac markers, and symptoms like shortness of breath and nausea likely has a high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Step-by-step explanation:

The presentation of ST-segment depression in leads II, III, and aVF, along with elevated cardiac serum markers and symptoms such as fatigue, shortness of breath, and nausea, are characteristic of an acute coronary syndrome (ACS). The absence of ST-segment elevation on the ECG further specifies that this is a case of non-ST-segment elevation ACS (NSTE-ACS).

Considering the symptoms' severity and the presence of nonsustained ventricular tachycardia, which is a risk factor for adverse outcomes, this suggests a high-risk situation. Therefore, the findings suggest the woman is experiencing a high-risk non-ST-segment elevation ACS (NSTE-ACS).