A 45-year-old man with a history of dyslipidemia presented to the emergency department with chest pain. Presentation He was awakened from sleep one hour earlier with burning, pressure-like substernal chest pain radiating to his left arm with associated nausea. He denied dyspnoea, diaphoresis, or lightheadedness. The pain was constant, not worse with exertion, and not relieved by an antacid medication. History He reported good health throughout his life, managing his dyslipidemia with diet and exercise and he did not take prescription medications.
The man’s family history was notable for coronary artery disease in his father. He denied smoking cigarettes and using any drugs, and was quite physically active in martial arts. Exam His blood pressure was 160/101 mm Hg on arrival, and his cardiovascular and respiratory examinations were unremarkable. A 12-lead electrocardiogram (image) and…
