A 58-year-old man, with no personal or family history of cardiovascular disease and with obesity (BMI, 35.4) as the sole cardiovascular risk factor, attended his health center with a 48-hour history of persistent nonexertion-related pain in his left arm. The patient had no previous fever or infectious process. He underwent ECG in the health center (Figure) and was referred to a hospital emergency room, where serial ECG failed to detect any alterations. In the hospital, serial determination of ultrasensitive troponin I showed normal values. The basic cardiological study was completed with echocardiography, which showed good biventricular systolic function, with no regional contractility alteration, valve disease, or pericardial effusion.
What diagnosis is indicated by the ECG?
- 1.
ST elevation acute coronary syndrome.
- 2.
Non-ST elevation acute coronary syndrome.
- 3.
Apical hypertrophic cardiomyopathy.
- 4.
Acute pericarditis.
Suggest a solution to this ECG Contest at http://www.revespcardiol.org/es/electroreto/69/10. The answer will be published in the next issue (November 2016). #RetoECG.