A 52-year-old man named Alan presents to a metropolitan emergency department with central, crushing chest pain radiating to his jaw and left arm. His wife noticed that he was looking pale and felt clammy. The pain came on over 5- 10 minutes after eating his dinner. Alan says the pain is 9/10 in severity and is associated with nausea and some shortness of breath. His medical history includes hypertension and type 2 diabetes mellitus. Alan has smoked 20 cigarettes daily for the past 27 years. His regular medications include Aspirin, Ramipril and Metformin. His brother had a heart attack at the age of 60 years.
On arrival at the emergency department you observe that Alan is overweight and looks visibly uncomfortable. His observations are as follows:
⢠Temperature: 366 degrees Celsius
⢠Heart rate: 70 bpm, regular
⢠Blood pressure: 159/88mmHg
⢠Respiratory rate: 28rpm
⢠Oxygen saturation: 95% on RA
⢠GCS: 15 PEARL
You perform an ECG (see below).
A 52-year-old man named Alan presents to a metropolitan emergency department wit
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