QuestionSBA
QuestionChoice
Costochondritis is a cause of chest wall pain that results from inflammation of the costal cartilage, the cartilage that connects the ribs to the sternum. It classically presents with pain when taking a deep breath or in certain positions. It often occurs after a recent illness with coughing or after intense exercise and is mostly of unilateral origin. The pain is reproduced on palpation of the affected area too - commonly ribs two to five.
10005249
d
Costochondritis
QuestionChoice
Myocarditis affects people of all ages (symptom onset is typically in those 20 to 50 years of age) and has a wide range of clinical presentations making its diagnosis challenging. Although it may be asymptomatic, the most common presenting features are chest pain (in 85–95% of cases), fever (in approximately 65%) and dyspnoea (19–49% of cases). Other features include palpitations, syncope and fatigue. Up to 80% of patients with acute myocarditis have prodromal symptoms. Patients may have a history of a preceding flu-like, respiratory and/or gastrointestinal illness, making this a less likely diagnosis.
10005250
e
Acute myocarditis
QuestionChoice
Chest pain typical of angina is defined by the following three features: constriction-like pain in chest/neck/arm/jaw, brought on by physical activity, and alleviated by rest or glyceryl trinitrate within minutes. Two out of three features indicate atypical angina pain.
10005246
a
Stable angina
QuestionChoice
Unstable angina is defined as myocardial ischaemia at rest or on minimal exertion in the absence of acute cardiomyocyte injury/necrosis. It is characterised by specific clinical findings of prolonged (>20 minutes) angina at rest; new onset of 'severe' angina; angina that is increasing in frequency, longer in duration, or lower in threshold; or angina that occurs after a recent episode of myocardial infarction. None of these apply to this case of stable angina.
10005247
b
Unstable angina
QuestionChoice
Acute Pericarditis is inflammation of the pericardial sac. It presents most often in men aged 20 to 50 years old with acute retrosternal, sharp, pleuritic chest pain that varies in severity. It is frequently exacerbated in the supine position, by coughing, and with inspiration. Classic ECG changes occur in around 90% of patients and include widespread concave upward ST-segment elevation and PR-segment depression without T-wave inversions.
10005248
c
Acute pericarditis
Concept
Chapter
2693
3721
Stable angina
Topic
134
Cardiology
13596
A 70-year-old man presents to the rapid access chest pain clinic with constricting discomfort in the front of his chest, precipitated by physical exertion and relieved by rest within five minutes. He has no relevant past medical history and had been well before this occurred. His examination is entirely normal with no chest wall tenderness and his resting ECG is in sinus rhythm.

Which of the following is the most likely diagnosis?
a