Perfect, you guys hit the nail on the head. Focal first diagonal occlusion. Images from before and after intervention is below. Angios films attached. The diagonal was found to have a thrombotic lesion. Post interventional flow was slightly sluggish, TIMI 2-3.

EKG post intervention below showing resolution of these changes and Q-wave progression:

Here is the next twist. 24 hr later, while he was in the hospital, he developed sudden-onset chest pain associated with diaphoresis and palpitations. He is tachycardic but BP is stable.

Repeat EKG is shown below.

What is going on now, what is the next step?