A man with ST segment depression

A man in his 40s presented to the emergency department with a nine hour history of mild intermittent chest discomfort, palpitations, and sweating. He had a history of well controlled hypertension and a previous posterior wall myocardial infarction nine years ago (an electrocardiogram (ECG) from that time is shown in fig 1). He had not been taking his cardiac or antihypertensive medication regularly.bmj;382/sep14_5/e076079/F1F1f1Fig 1ECG at myocardial infarction nine years before this presentationInitial physical examination showed his body temperature to be 36.4°C, blood pressure 126/106 mm Hg, pulse rate 95 beats/min, and respiratory rate 16 breaths/min. An ECG was obtained (fig 2). A high sensitivity cardiac troponin I assay (Beckman Coulter Access hsTnI) showed his levels to be elevated at 472.3 ng/L (99th centile for men is 0-19.8 ng/L.)bmj;382/sep14_5/e076079/F2F2f2Fig 2ECG obtained in the emergency department on presentationQuestionsWhat does the ECG in figure 2 show?What is the most likely diagnosis?How should this…
Read Original Article: A man with ST segment depression »