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He reports significant chestpain at the base of his scapula on the right side along with new shortness of breath. Wellen's waves indicate that, when the patient was having chestpain, there was occlusion. See these casese (and I have many others): First ED ECG is Wellens' (pain free). A 70-something y.o.
A middle-aged woman had intermittent angina for 48 hours, then onset of constant, crushing chestpain for 1.5 Post-infarction Regional Pericarditis (PIRP) PIRP happens when MI is transmural, all the way from subendocardium to subepicardium, thus leading to inflammation of the subepicardium (next to the pericardium).
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