You're taking home call as the cardiology fellow when your sleep is interrupted by beeping of your fax machine. You get the EKG shown above; darn the quality of those faxed copies! The resident calls with the story: a fifty year old gentleman with hypertension, diabetes, dyslipidemia, and gout presents with several minutes of substernal crushing chest pain radiating to the jaw and left arm. This pain is accompanied by dyspnea, nausea, and diaphoresis. Troponins are negative. The EKG is shown above. Apparently, this man had a perfectly normal EKG one year ago.
Challenge: Do you drive into the hospital to cath this guy? If no, why not? If yes, where is the lesion?
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