Would like to share this case from last week. It is an acute MI but with a couple of twists in presentation that I thought worth sharing.

A 61 year-old-male with family h/o CAD. Presented to ED with 30 min of left sided chest pain radiates to the left shoulder. EKG on arrival shown.

Initial hs-cTnT: 7 and 1-hr later was 11 (normal NTG lowered CP from 10/10 to 4/10, morphine helped as well.

Repeat hs-cTnT at 3-hr is: 41. EKG 2 hours later shown:

The patient was taken to the Cath lab and found to have a coronary lesion.  Where is that lesion?