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Clinical Chinese questions with pinyin, an English glossary, and step-by-step explanations. Try 5 free — no signup.
Internal medicine · Cardiology
男，62岁。突发胸骨后剧烈疼痛2小时，伴大汗，含服硝酸甘油不能缓解。心电图示II、III、aVF导联ST段弓背向上抬高。最可能的诊断是
Male, 62. Sudden severe retrosternal pain for 2 hours with profuse sweating, not relieved by sublingual nitroglycerin. ECG shows convex (dome-shaped) ST elevation in leads II, III and aVF. The most likely diagnosis is
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100 questions (incl. 5 free samples) across Internal Medicine, Surgery, OB/GYN, Pediatrics. Lifetime access.
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Example of a Pro explanation
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Answer key: D. Acute inferior myocardial infarction. This text is saved on the page. It does not call the model.
1. What the Chinese says
A 62-year-old man has sudden severe pain behind the sternum for 2 hours, with heavy sweating. Nitroglycerin under the tongue does not relieve it. The ECG shows dome-shaped ST elevation in leads II, III and aVF.
2. Key words
心肌梗死 (xīnjī gěngsǐ) means myocardial infarction. ST段抬高 (ST duàn táigāo) means ST-segment elevation. 下壁 (xiàbì) means the inferior wall. Leads II, III and aVF look at that wall.
3. Why this answer
Pain that lasts and is not relieved by nitroglycerin, plus ST elevation in II, III and aVF, places an acute myocardial infarction on the inferior wall. The answer key is D, acute inferior myocardial infarction.
4. Why not the others
Stable angina usually lasts only a few minutes and eases with rest or nitroglycerin; this pain has lasted 2 hours and does not ease. An anterior infarction shows ST elevation in the precordial leads (V1–V5), not in II, III and aVF. Acute pericarditis gives widespread concave (saddle-shaped) ST elevation in most leads except aVR and V1, often with PR depression and no reciprocal ST depression; here the ST elevation is convex and confined to the inferior leads. Aortic dissection typically causes tearing pain radiating to the back with unequal arm blood pressures; nothing in the stem points to it.
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