Acute Myocardial Ischaemia

• A 50 y.o. man in Accident and Emergency with a week of chest discomfort without ECG abnormality...
• Four years later he presents with one hour of severe chest discomfort, dyspnoea and inferior ST elevation on first ECG...
• Later, in his 60s the patient presents with oppressive chest discomfort, ashen appearance, tachycardia/tachypnoea and new anterior ST elevation...