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A 60-year-old man has had angina on exertion for the past 6 years. A coronary angiogram performed 2 years ago showed 75% stenosis of the left circumflex coronary artery and 50% stenosis of the right coronary artery. For the past 3 weeks, the frequency and severity of his anginal attacks have increased, and pain sometimes occurs even when he is lying in bed. On physical examination, his blood pressure is 110/80 mm Hg, and pulse is 85/min with irregular beats. An ECG shows ST segment elevation. Laboratory studies show serum glucose, 188 mg/dL; creatinine, 1.2 mg/dL; and troponin I, 1.5 ng/mL. Which of the following is most likely to explain these findings?
A.
Atheromatous plaque fissure with thrombosis
B.
Constrictive pericarditis with calcification
C.
Endomyocardial fibrosis
D.
Extensive myocardial fiber hypertrophy
E.
Left ventricular mural thrombosis
F.
Mitral valve prolapse with regurgitation