A 50-year-old man presented to the Emergency Department with ongoing central chest pain, which started four hours ago. He described it as a dull pain that did not radiate. He felt short of breath, sweaty, and nauseous with the pain. There was no objective evidence of dyspnea, but the patient looked clammy. There was no previous history or risk factors for coronary heart disease except tobacco smoking.

Physical examination and baseline observations were unremarkable. The ECG was recorded and is provided here for your reference. (Cover image) Interpret the ECG and diagnose this patient's condition. *This Case Challenge is from the Editorial Team of Docplexus and is meant for educational purposes only.