A 69-year-old man complains of tightness in the chest and shoness of breath after lifting boxes 3 hours ago. He perceives that his hea is skipping beats. His medical history is significant for hypeension and cigarette smoking. On examination, his hea rate is 50 beats/min and regular, and his lungs are clear to auscultation. An electrocardiogram shows bradycardia with an increased PR interval and ST-segment elevation in multiple leads including the anterior leads, V1 and V2. What anatomical structures are most likely affected?
High-Yield Explanation
This patient's 3-hour history of worsening chest pain, dyspnea, and palpitations after physical exeion is classic for a myocardial infarction. This patient's risk factors include hypeension and tobacco use. The ECG (ST-segment elevation) is highly suspicious for myocardial infarction. Leads V1 and V2 are used to evaluate the anterior poion of the hea, which is supplied by the left anterior descending aery. Bradycardia and first-degree hea block (increased PR interval) indicate right coronary aery disease.