by Khalid Mohammed Ali, Shirley Ooi from Singapore.
A 46 years old man with a past medical history of hypertension and hyperlipidemia developed central crushing chest pain associated with sweating and shortness of breath while driving. He presented to the emergency department 1 hour after the onset of chest pain. On physical examination, his vital signs were as follows; pulse rate: 60 beats per minute, blood pressure: 100 over 50 mmHg, respiratory rate: 20 per minute, Oxygen Saturation: 98% on room air. Patient has no leg edema, new murmur or features of heart failure. ECG is given on the side.