Acute coronary syndrome
Substernal pressure with left arm radiation, exertional worsening, diaphoresis, nausea, and multiple vascular risk factors makes ACS the leading diagnosis in this example.
Suggested next steps
- Immediate ECG
- Serial troponins
- Risk stratification and emergency protocol review
Red flags
- Persistent pain at rest
- Hemodynamic instability
- Dynamic ischemic ECG changes