1 Hour Of Sudden in Medicine / Internal Medicine — 40yo Man | Cardiology | SMLE Q#18627
SMLE Question #18627
Medicine / Internal Medicine
Cardiology
Objective: OBJ-IM-CARD-ACS-RISK
Last updated: February 2026
A 40-year-old man presents to the emergency department with 1 hour of sudden retrosternal chest pressure radiating to the neck, associated with diaphoresis and nausea. He has no prior cardiac history. Physical examination is unremarkable. ECG shows horizontal ST-segment depression in leads II, III, and aVF consistent with subendocardial ischemia. Among the following, which is the most important modifiable risk factor for this presentation?
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