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Mr. H reports that the sharp pain started about 2 days ago and it has gotten so bad that he cannot lie down.

Mr. H reports that the sharp pain started about 2 days ago and it has gotten so bad that he cannot lie down. He rates the pain as an 8 on a scale of 1 to 10, and it radiates to his neck and back. It is much worse when he takes a deep breath, but leaning forward seems to help him. He is on lisinopril for his high blood pressure and denies any other health problems. Family history is significant for heart disease and hypertension.

What labs would be helpful in confirming or ruling out a myocardial infarction, and what are the advantages of each?

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If Mr. H has acute coronary syndrome, what ECG changes are expected?

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