45 Minutes Of Sudden in Medicine / Internal Medicine — 40yo Man | Cardiology | SMLE Q#11978
SMLE Question #11978
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 40-year-old man presents to the emergency department with 45 minutes of sudden retrosternal chest pain radiating to the neck, associated with diaphoresis and mild shortness of breath. He reports no known diabetes mellitus, dyslipidaemia, or premature coronary artery disease in first-degree relatives, and he has not been diagnosed with chronic hypertension. He smokes 1 pack of cigarettes daily for 20 years. ECG shows ST-segment depression in leads II, III, and aVF. Which of the following is the most important major risk factor for his condition?
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