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Retired NBME 16 Answers

nbme16/Block 1/Question#27 (reveal difficulty score)
A 62-year-old man with unstable angina ...
Left coronary ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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Here is a diagram showing the coronary arteries.

Important related facts to remember:

  • LAD (left anterior descending) comes off left coronary - LAD is blocked in anterior infarctions
  • LCX (left circumflex) comes off left coronary and the left marginal artery comes off the LCX - LCX is blocked in lateral infarctions and some posterior (if left dominant)
  • Right coronary artery supplies the entire right side of the heart and gives rise to the right marginal artery - RCA is blocked in most posterior infarctions and infarctions affecting the right ventricle
  • Which artery gives rise to the posterior descending artery determines the "dominance" of the heart - PDA from the RCA is right dominant [right dominant is most common], PDA from the left circumflex is left dominant

Also found FA2020 p283

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