42 yr old male with sudden onset severe retrosternal chest pain began 1 hour ago. Pain is described as sharp, constant, and unrelated to to movement. Not relieved by 3 doses of nitroglycerin. Hx: Hypertension- takes Enalapril Vitals: 118bpm, 156/64 mmHg on RT arm, 188/74 on LT arm.
Myocardial infarction (90%)....or may be peptic ulcer or gall bladder stone....cant decide without ECG