Rosh Emergency Medicine Practice Test

A patient with a suspected myocardial infarction is most likely to exhibit which symptom?

1. Rapid weight gain

2. Abdominal pain

3. Shortness of breath

4. Hypertension

The correct answer is: Shortness of breath

In the context of a suspected myocardial infarction (MI), shortness of breath is commonly reported by patients and is a significant symptom of acute coronary conditions. This discomfort can arise due to several factors associated with an MI, such as decreased oxygen supply to the heart muscle, resulting in pulmonary congestion if the heart is unable to pump effectively. As a consequence, this can lead to fluid backing up into the lungs, creating symptoms of dyspnea or shortness of breath. While the other symptoms listed might occasionally be associated with myocardial infarction, they are not as characteristic or prevalent as shortness of breath. For example, rapid weight gain may be observed in cases of fluid retention but is not directly indicative of an MI. Abdominal pain can occur, sometimes referred to as epigastric pain, which might confuse the diagnosis but is less specific than the thoracic symptoms. Hypertension may be present but is not a direct symptom of an MI; rather, it's an underlying factor that can complicate the clinical picture. In summary, shortness of breath is a key symptom commonly seen in patients experiencing a myocardial infarction, reflecting the acute stress on cardiac function and potential pulmonary complications.