49M brought in by EMS c/o heavy, sharp chest pain for 45 min | Figure 1

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49M brought in by EMS c/o heavy, sharp chest pain for 45 mins. Pt is very diapheteric with BP in 180's and climbing. Elevated trop of 0.109. Cardio consulted and advised to start on heparin and Nitro. Pt admitted to cvicu. CTA done after admission.