Sudden Sharp Central Chest in Medicine / Internal Medicine — 28yo Man | Cardiology | SMLE Q#11557

SMLE Question #11557

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 28-year-old man presents to the emergency department with sudden sharp central chest pain that worsens when lying supine and improves when sitting forward. He reports mild dyspnea on exertion. Cardiac examination reveals a superficial scratchy sound best heard at the left sternal border. ECG shows diffuse concave ST-segment elevation without reciprocal ST depression. High-sensitivity troponin is within the reference range. What is the most appropriate initial treatment?

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