ANSWER 4 =B

The patient has a high risk for coronary artery disease because of the high pack-year history of smoking and high blood pressure. The presenting symptoms suggests angina pectoris of new onset. By definition this is managed as crescendo angina. Furthermore, the EKG findings suggest acute obstruction of the right coronary artery (ST-segment elevation in leads III and II – inferior leads- plus reciprocal ST-segment depression in leads I and lead aVL – anterior leads.) A review on the Diagnosis of Acute Coronary Syndrome can be found in the reference below. Achar SA, Kundu S, Norcross W. Am Fam Physician 2005;72:119-26.