You are working a typical shift in the ED when an otherwise healthy 33 yo male presents with 2 hours of chest pain. He reports ~3-4 episodes of vomiting over past few days as well as myalgias & subjective fevers. Two hours prior to arrival, he awoke with mid-sternal chest pain. The chest pain is burning in quality, non-radiating, worse with deep inspiration. He denies any current nausea or SOB, prior history of similar episodes or calf swelling or pain. You are general unimpressed, but of course get the EKG anyway:
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