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MRCP Part 2 Written Question of the Day

Try our Question of the Day and test your knowledge. Questions include themes similar to April 2014 MRCP Part 2 Written exam.

A 76-year-old man presented to the Emergency Department after a syncopal episode at home.

He recovered spontaneously but his wife, who witnessed the episode, insisted that he go to hospital. His only recollection of the episode was that he suddenly felt light-headed and then he passed out. He said that the episode was not preceded by chest pain or breathlessness. He had a previous history of an anterior myocardial infarction (MI) three months previously.

On examination, he appeared well. His pulse was 80 beats per minute and regular with a blood pressure of 110/70 mmHg. He had a diffuse apex beat. The heart sounds were normal with no added sounds or murmurs.

A 12-lead ECG showed ST segment elevation in leads V3 to V6 and frequent ventricular extrasystoles. A serum troponin-T, taken twelve hours after the episode, was normal.

What is the most likely diagnosis?

(Please select 1 option)

Acute lateral myocardial infarction
Heart failure with secondary ventricular tachycardia
Intermittent complete heart block post-myocardial infarction
Left ventricular aneurysm with secondary ventricular tachycardia
Postural hypotension due to poor left ventricular function

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