A 53-year-old old Healthy man presents with three hours of severe unrelenting retrosternal chest tightness. This is associated with shortness of breath and sweating. The discomfort started when he was gardening (usual activity) but would not get relieved with rest, water and Tums. He has never had chest Pain before and has not seen a doctor for over 2 years. He smokes 1 packet of cigarettes a day and is an occasional drinker and has been doing so for over 17 years.
He denies HTN and Diabetes. What is the likely diagnosis? What is the differential diagnosis? How will the diagnosis be confirmed? How should this patient be treated?