A woman in her 70s presented to the emergency department with chest pain of 30 minutes’ duration. Her medical history included coronary artery disease, ischemic cardiomyopathy, and tachycardia-bradycardia syndrome with atrial fibrillation. She had previously undergone implantation of a dual-chamber pacemaker, subsequently upgraded to a biventricular pacing system for cardiac resynchronization therapy in the setting of worsening left ventricular ejection fraction (<35%) and high pacemaker dependence.
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Simpson TF, Rahman S, Goldschlager N. Enhancing the Sgarbossa Criteria for the Diagnosis of ST Elevation Myocardial Infarction. JAMA Intern Med. 2019;179(4):564–566. doi:10.1001/jamainternmed.2018.7993
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