{"id":2302,"date":"2021-11-03T22:37:00","date_gmt":"2021-11-03T22:37:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=2302"},"modified":"2025-10-01T11:40:33","modified_gmt":"2025-10-01T19:40:33","slug":"usmle-step-2-ck-question-of-the-day-chest-pain","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain","title":{"rendered":"USMLE\u00ae Step 2 CK Question of the Day: Chest Pain"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#Check_out_our_free_USMLE%C2%AE_Step_2_Ultimate_Guide\" >Check out our free&nbsp;USMLE\u00ae Step 2 Ultimate Guide!<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_2_CK_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 2 CK Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#A_Open_vascular_repair\" >A. Open vascular repair<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#B_IV_esmolol\" >B.&nbsp;IV esmolol<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#C_Thrombolytic_therapy\" >C. Thrombolytic therapy<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#D_Coronary_revascularization\" >D. Coronary revascularization<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#E_Pericardiocentesis\" >E. Pericardiocentesis<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>We&#8217;re back with a USMLE\u00ae Step 2 CK Question of the Day!&nbsp;<strong><em>Today&#8217;s case involves a 66-year-old man with sharp chest pain. What would be the most appropriate definitive treatment for this patient\u2019s condition?<\/em><\/strong><\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 66-year-old man presents to the emergency department with sudden onset sharp chest pain radiating to the back. The patient reports he has a history of long-standing hypertension, but he has not taken his medications in quite some time. His temperature is now 37.0\u00b0C (98.6\u00b0F), pulse is 120\/min, respirations are 23\/min, blood pressure is 85\/60 mmHg, and oxygen saturation is 94% on room air. Physical examination shows 1+ peripheral pulses in the right upper extremity and 2+ pulses in the left upper extremity. Neurological examination shows 3\/5 power in the left upper and lower extremities compared to 5\/5 power in the right upper and lower extremities. Cardiovascular examination reveals muffled heart sounds. An ECG is obtained, which shows non-specific T-wave changes as well as electrical alternans. Non-contrast CT-brain is normal. Which of the following is the most appropriate definitive treatment for this patient\u2019s condition?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Open vascular repair<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. IV esmolol<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Thrombolytic therapy<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Coronary revascularization<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Pericardiocentesis<\/strong>Scroll down for the correct answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Osmosis Around the World: Saudi Arabia\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/xYlj433bL4w?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Check_out_our_free_USMLE%C2%AE_Step_2_Ultimate_Guide\"><\/span>Check out our free<a href=\"https:\/\/www.osmosis.org\/ultimate-guide\/usmle-step-2\" target=\"_blank\" rel=\"noreferrer noopener\">&nbsp;USMLE\u00ae Step 2 Ultimate Guide!<\/a><span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_2_CK_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 2 CK Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Open_vascular_repair\"><\/span>A. Open vascular repair<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s see why the answer wasn&#8217;t B, C, D or E. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Today&#8217;s incorrect answers are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_IV_esmolol\"><\/span>B.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Adrenergic_antagonists:_Beta_blockers\" target=\"_blank\" rel=\"noreferrer noopener\">IV esmolol<\/a><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong>&nbsp;Blood pressure management is the definitive therapy for type B&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Aortic_dissection\" target=\"_blank\" rel=\"noreferrer noopener\">aortic dissections<\/a>, which occur distal to&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Anatomy_of_the_superior_mediastinum\" target=\"_blank\" rel=\"noreferrer noopener\">the ligamentum arteriosum<\/a>&nbsp;and involve only the descending aorta. The patient in this vignette has concerning features for pericardial tamponade given the muffled heart sounds and the electrical alternans on ECG. Pericardial effusions and subsequent tamponade are uncommon sequelae of type B aortic dissections and more common with type A aortic dissections.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Thrombolytic_therapy\"><\/span>C. Thrombolytic therapy<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>Thrombolytic therapy may be the treatment for&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Ischemic_stroke\" target=\"_blank\" rel=\"noreferrer noopener\">an ischemic stroke<\/a>&nbsp;or massive PE; however, the definitive treatment for this patient\u2019s condition is endovascular repair of the ascending aorta. While PE is possible, the patient is this vignette is not hypoxic, and no signs of right ventricular strain are noted on his ECG, making the diagnosis of a massive PE less likely. The patient in this vignette is likely suffering a stroke from an aortic dissection; however, administration of thrombolytics in this situation may precipitate uncontrolled bleeding into the dissection and worsen the hemodynamic compromise.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Coronary_revascularization\"><\/span>D. Coronary revascularization<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>While aortic dissections can mimic findings of acute MI due to compression on the coronary vessels, definitive therapy for type A aortic dissection involves endovascular repair of the ascending aorta. Patients with a true MI usually present with dull, pressure-like pain, worsened on exertion, and relieved with rest or nitroglycerin. Neurologic deficits are an uncommon feature of isolated myocardial infarctions.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Pericardiocentesis\"><\/span>E. Pericardiocentesis<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:&nbsp;<\/strong>The patient in this vignette does have exam features concerning for&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Cardiac_tamponade\" target=\"_blank\" rel=\"noreferrer noopener\">pericardial tamponade<\/a>, including electrical alternans, muffled heart sounds, hypotension and tachycardia. While pericardiocentesis may improve this patient\u2019s hemodynamic instability, the definitive treatment for this patient\u2019s condition involves repair of the aorta to prevent further pericardial tamponade.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span><strong>Main Explanation<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The patient in this vignette has concerning features for an&nbsp;<strong>aortic dissection<\/strong>&nbsp;including sudden onset, sharp chest pain radiating to the back, with associated findings of&nbsp;<strong>hypotension, pericardial tamponade,&nbsp;<\/strong><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Myocardial_infarction\" target=\"_blank\" rel=\"noreferrer noopener\">myocardial infarction<\/a><\/strong>, and<strong>&nbsp;focal neurologic deficits<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Aortic dissections are caused by longitudinal cleavage of the aortic media created by a dissecting column of blood. They are a potentially catastrophic vascular complication that can cause end organ&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Ischemia\" target=\"_blank\" rel=\"noreferrer noopener\">ischemia&nbsp;<\/a>to a variety of organs &#8211; namely the brain and the heart. Aortic dissections are divided into two categories: Stanford type A<strong>&nbsp;<\/strong>and Stanford type B.<strong>&nbsp;Stanford type A dissection<\/strong>&nbsp;involves the<strong>&nbsp;ascending aorta<\/strong>&nbsp;and more commonly leads to<strong>&nbsp;hypotension<\/strong>,<strong>&nbsp;pericardial tamponade<\/strong>,&nbsp;<strong>stroke<\/strong>, and<strong>&nbsp;myocardial infarction (MI)<\/strong>. The definitive management of Type A dissection is&nbsp;<strong>surgical repair.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Stanford type B dissections&nbsp;<\/strong>occur distal to the ligamentum arteriosum and involve only the<strong>&nbsp;descending aorta<\/strong>. Type B dissections can also present with stroke-like symptoms, if for example the dissection were to progress retrograde and involve the left common carotid artery; however, this would produce right sided weakness, as opposed to left sided weakness seen in this patient. Type B dissections rarely dissect retrograde to yield tamponade, but they can progress anterograde to compromise blood flow to the renal arteries, resulting in&nbsp;<strong>acute renal failure<\/strong>. The definitive therapy for Stanford type B dissections is&nbsp;<strong>blood pressure control&nbsp;<\/strong>with either beta blockers, like esmolol, or vasodilators.vasodilators.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"605\" height=\"823\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T164043.882.png\" alt=\"Table of aortic dissection - risk factors, clinical features, complications, type, location, treatment.\" class=\"wp-image-2305\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T164043.882.png 605w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T164043.882.png?resize=221,300 221w\" sizes=\"auto, (max-width: 605px) 100vw, 605px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span><strong>Major Takeaway<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Stanford type A aortic dissections&nbsp;<\/strong>involve the proximal aorta and are treated with emergent&nbsp;<strong>surgical repair<\/strong>.&nbsp;<strong>Stanford type B&nbsp;<\/strong>aortic dissections<strong>&nbsp;<\/strong>occur distal to the ligamentum arteriosum and are treated by strict&nbsp;<strong>blood pressure control<\/strong>.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Aneurysms - causes, symptoms, diagnosis, treatment, pathology\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/A5MEe0lb0YA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span><strong>References<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Cambria RP. Surgical treatment of complicated distal aortic dissection.&nbsp;<em>Semin Vasc Surg<\/em>. 2002;15(2):97\u2010107.&nbsp;<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12060899\/\" target=\"_blank\" rel=\"noreferrer noopener\">doi:10.1053\/svas.2002.33439<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Kumar, V., Abbas, A. K., Aster, J. C., &amp; Robbins, S. L. (2013).&nbsp;<em>Robbins Basic Pathology<\/em>&nbsp;Philadelphia: Elsevier\/Saunders<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Curry, M. (2017, May 18). Rosen&#8217;s Emergency Medicine: Concepts and Clinical Practice. Retrieved from&nbsp;<a href=\"https:\/\/www.us.elsevierhealth.com\/rosens-emergency-medicine-concepts-and-clinical-practice-9780323354790.html\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.us.elsevierhealth.com\/rosens-emergency-medicine-concepts-and-clinical-practice-9780323354790.html<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u2013\u2013\u2013\u2013\u2013\u2013\u2013\u2013\u2013\u2013\u2013\u2013<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><br><strong>Want more &nbsp;USMLE\u00ae Step 2 CK practice questions?&nbsp;<\/strong><\/em><em><strong>Try Osmosis today!&nbsp;<\/strong><\/em><em><strong><a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">Access your free trial<\/a><\/strong><\/em><em><strong>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T164218.841.png\" alt=\"Ace your clerkships with clinical practice videos on Osmosis. Watch now.\" class=\"wp-image-2306\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T164218.841.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/2024-09-11T164218.841.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>We&#8217;re back with a USMLE\u00ae Step 2 CK Question of the Day!&nbsp;Today&#8217;s case involves a 66-year-old man with sharp chest pain. What would be the most appropriate definitive treatment for this patient\u2019s condition? A 66-year-old man presents to the emergency department with sudden onset sharp chest pain radiating to the back. The patient reports he [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":2304,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,20,45],"tags":[],"class_list":["post-2302","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-exam-prep","category-step-2"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 2 CK Question of the Day: Chest Pain - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-2-ck-question-of-the-day-chest-pain\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 2 CK Question of the Day: Chest Pain - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"We&#8217;re back with a USMLE\u00ae Step 2 CK Question of the Day!&nbsp;Today&#8217;s case involves a 66-year-old man with sharp chest pain. What would be the most appropriate definitive treatment for this patient\u2019s condition? A 66-year-old man presents to the emergency department with sudden onset sharp chest pain radiating to the back. 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