A 54-year-old man has presented to the emergency department with central, crushing chest pain radiating to his left arm and jaw. The pain came on over 5–10 minutes after he had been running for a bus. He says the pain is 9/10 in severity and is associated with nausea and shortness of breath. His medical history includes hypertension and type 2 diabetes mellitus. He has smoked 20 cigarettes per day for 30 years. His regular medication includes aspirin, ramipril and metformin.

Examination This man is overweight and visibly uncomfortable. His heart rate is 100/min and blood pressure 140/88 mmHg. He was given 300 mg of aspirin and a glyceryl trinitrate (GTN) spray which eased the pain. An ECG was performed, which was normal. What diagnosis do his symptoms suggest? *This case is from Docplexus team for educative purpose only Source: Cases in acute medicine