A 35-year-old male with no significant past medical history…

A 35-year-old male with no significant past medical history presents to the Emergency Department with one day of worsening chest pain. The chest pain was abrupt in onset, is described as “sharp” in nature, and worsens with inspiration. It is primarily centered in the center of his chest but occasionally radiates to the left upper back. He feels that the pain worsens when he lays down. Vital signs are unremarkable including equal bilateral upper extremity blood pressures and radial pulses. On physical examination, he is febrile to 38.2°C. A triphasic “scratching” sound in time with the cardiac cycle is auscultated at the left lower sternal border. Initial laboratory studies show a negative troponin T and mild elevations in white blood cell count and the C-reactive protein. His ECG is shown below: ECG6.jpg Which of the following is the most appropriate next step?

Again, remember that your webcam must be pointed so that BOT…

Again, remember that your webcam must be pointed so that BOTH hands and your desktop AND your face can be clearly seen for the entire duration of the quiz. Note that this needs to be a front view of your face. This quiz is closed book. The use of any resources including devices, websites or notes, is a violation of academic integrity.  Failure to follow the rules of this quiz will result in a ZERO on the quiz.