Cardiology Case Report: Nonpleuritic Chest Pain

This cardiology case report from Brady Pregerson, MD, features a patient in their early 70s presenting to the hospital with reports of shortness of breath, palpitations, and chest pain. Can you determine the correct diagnosis?

Case History:

A patient in their early 70s presents to the hospital with shortness of breath, palpitations, and chest pain starting around 9 AM. The chest pain was left-sided, radiated to the left arm, was nonpleuritic, and lasted for about 2 hours before it gradually resolved. She denies any pain on inspiration, leg swelling or pain, syncope, fever, cough, or other complaints.

Exam:

Vital signs are normal except for tachycardia. The physical exam is otherwise normal.

An ECG is Performed:

What is the most likely cause of the ECG findings in this patient?