45 Minutes Of Sudden in Medicine / Internal Medicine — 58yo Man | Cardiology | SMLE Q#17152

SMLE Question #17152

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 58-year-old man presents to the emergency department with 45 minutes of sudden crushing central chest pain radiating to the left arm, with diaphoresis and nausea. He has hypertension, hyperlipidaemia, and smokes. Examination shows an anxious, diaphoretic man; heart sounds are normal and lungs are clear. ECG shows ST-segment elevation in V2–V6, I and aVL with reciprocal ST depression in III and aVF. What is the most likely diagnosis?

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