Case synopsis

A 54-year-old obese lawyer presents to your hospital, which is equipped with cardiac catheterization or revascularization facilities, but has no designated 'direct PCI' suite. The patient has the following complaints/characteristics:

• 3 hours of chest pain radiating to left arm and jaw
• Dyspnea and diaphoresis

The patient has prior history of:

• Hypertension treated with angiotensin receptor blocker (ARB)
• Hyperlipidaemia treated with a statin but patient was not compliant with therapy
• Smoking (1.5 packs/day for 35 years)