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He denied any known medical history, specifically: coronary artery disease, hypertension, dyslipidemia, diabetes, heart failure, myocardialinfarction, or any prior PCI/stent. Learning points 1] Acute Coronary Syndrome has many shades of clinical manifestation. Breath sounds were clear in all lung fields.
Smith , d and Muzaffer Değertekin a DIFOCCULT: DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardialinfarction. His first electrocardiogram ( ECG) is given below: --Sinus bradycardia. Here is the coronaryangiogram: A distal thrombotic right coronary artery (RCA) occlusion !
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Bradycardia 
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