John Budd is a 62-year-old man who experienced chest pain at work and was brought to the Emergency

John Budd is a 62-year-old man who experienced chest pain at work and was brought to the Emergency Room (ER) by ambulance. You have been asked to see him. ohn is alone. It is 14:00 hours. The paramedic hands over as follows: “62-year-old male, central chest pain at rest at work today at 13:00 hours, lasted around 30 minutes, terminated with Nitroglycerin spray and IV morphine. Given aspirin 300mg. EKG shows sinus rhythm. Pain free now. Vital signs normal. Over to you doc.” John describes his symptoms:”I went to work as usual, felt a bit tired today but nothing to write home about. I was walking up the stairs to my office when I felt this awful pain in my chest, like someone had grabbed my insides and was squeezing hard. I broke out in to a cold sweat. A colleague came and said I looked really pale and was gasping for breath. The sweat was just pouring off me. She made me sit down on the stairs and called 911. The pain faded away after they gave me an injection.” John’s only past medical history is type 2 diabetes. He is taking metformin ER 1g twice a day and

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