Clinical Images in Medicine: An Abnormal Electrocardiogram in A Patient with Chest Pain

A case study of 70 year old male patient with a history of long standing diabetes mellitus (DM), hypertension, dyslipidemia, peripheral vascular disease, severe ischemic cardiomyopathy with LV ejection fraction of 20% and a left bundle branch block. He presented to the ER complaining of retrosternal chest pain for less than 6 hours associated with shortness of breath, orthopnea and diaphoresis. No paroxysmal nocturnal dyspnea or leg swelling.