Chest Pain in a Patient With a Left Bundle Branch Block

A 76-year-old woman presented to the emergency department with acute chest pain for 20 minutes. The chest pain radiated to the neck, jaw, and teeth, and was associated with nausea, dyspnea, and diaphoresis. The patient was hemodynamically stable and appeared only slightly uncomfortable. The cardiac and pulmonary examination results were normal, and the remainder of the examination was unremarkable. The ECG on arrival is shown in Figure 1. No previous ECGs were available.

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