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A 53-year-old high school teacher begins experiencing a cough after a parent-teachers conference. Initially it was a mild cough and the teacher thought nothing of it since he had a history of asthma. As he was driving home, the cough became more intense, and he began experiencing chest tightness. He used his rescue inhaler as usual but did not get any relief. Minutes later he began experiencing chest pain, unlike the tightness that he experienced with his asthma. He began to sweat profusely, experience light-headedness and difficulty breathing. He attempted to pull into a park but passed out and struck the curve causing his vehicle to come to a stop. A passerby saw the incident and called 9-1-1. On the scene, the paramedic found the man unconscious. His EKG revealed ST segment elevation in the anterior leads (V3 and V4), his pulse was shallow, and respirations were 10 breaths/min. Upon arrival to the ER, a troponin level was 13ng/l and his CK level was 263 U/L.
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