Cardiology: acute coronary syndrome: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: acute coronary syndrome

Sample item

A patient develops crushing central chest pain with ST-segment elevation in the inferior leads and is hypotensive with clear lungs. Which complication should be actively considered before giving nitrates?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Right ventricular infarction

Inferior STEMI can involve the right ventricle, making cardiac output preload-dependent. Nitrates may precipitate marked hypotension in this setting.

Option by option

  • A. Right ventricular infarction (correct)

    Correct. Right ventricular infarction commonly accompanies inferior infarction and is sensitive to preload reduction.

  • B. Aortic regurgitation

    Aortic regurgitation does not explain this acute inferior-STEMI pattern.

  • C. Stable angina

    Stable angina is exertional and should not cause persistent ST elevation or shock.

  • D. Acute pericarditis

    Pericarditis causes positional pleuritic pain and diffuse rather than inferior-only ST elevation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Right ventricular infarction. Inferior STEMI can involve the right ventricle, making cardiac output preload-dependent.

Why is "Aortic regurgitation" not the answer?

Aortic regurgitation does not explain this acute inferior-STEMI pattern.

Why is "Stable angina" not the answer?

Stable angina is exertional and should not cause persistent ST elevation or shock.

Why is "Acute pericarditis" not the answer?

Pericarditis causes positional pleuritic pain and diffuse rather than inferior-only ST elevation.

What concept does this question test?

It tests Cardiology: acute coronary syndrome in General Medicine. Nitrates may precipitate marked hypotension in this setting.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: acute coronary syndrome?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.