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USMLE 2CK Practice Question for August 18th

A 40-year-old man with a history of hypertension and type 2 diabetes is brought to the emergency room via ambulance because of nausea and abdominal pain for 4 hours. He describes severe, dull epigastric pain shortly after eating his evening meal. He appears pale and is sweating profusely. On physical examination, the lungs are clear to auscultation. Cardiovascular examination shows muffled heart sounds with absence of murmurs or rubs. A standard 12-lead electrocardiogram reveals Q waves and ST-segment elevation in leads II, III, and aVF. Which of the following findings is most specific for a diagnosis of right ventricular infarction?

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