National Board of Chiropractic Examiners (NBCE) Practice Test

What is the most likely diagnosis for a 50-year-old patient with a recent history of recurring exercise-induced chest pain that dissipates following 5-10 minutes of rest?

1. Coronary artery disease

2. Myocardial infarction

3. Pericarditis

4. Aortic dissection

The correct answer is: Coronary artery disease

The scenario described, featuring a 50-year-old patient with exercise-induced chest pain that resolves with 5-10 minutes of rest, is characteristic of angina pectoris, which is often associated with coronary artery disease (CAD). Angina occurs when the heart muscle does not receive enough blood and oxygen, typically due to blockages in the coronary arteries, leading to chest pain during physical activity or stress. The transient nature of the chest pain, specifically the fact that it dissipates within a brief period following rest, reinforces the likelihood of angina rather than other conditions. In contrast, myocardial infarction typically presents with more severe, unrelenting chest pain not easily relieved by rest. Pericarditis may present with chest pain as well, but the pain is often sharp and worsens with breathing or lying down, rather than being specifically exercise-induced. Aortic dissection usually leads to sudden, severe pain that is often described as tearing and does not resolve with rest, and is a medical emergency. Thus, the symptoms and their resolution pattern align most closely with coronary artery disease, affirming it as the most probable diagnosis in this context.