Case presentation  After two and a half hours of discomfort in the midsternal chest, neck, and shoulders, a 63-year-old female was admitted to the emergency ward. The doctor gave her sublingual nitroglycerin (0.4 mg) and morphine (2 mg) immediately.

She is a smoker and has a history of depression, hypertension, and gastroesophageal reflux disease. An initial cardiovascular test showed a regular rhythm with no gallops or murmurs.