Viewpoint: Another typical ST-segment elevation myocardial infarction in the elderly?

A woman presented to the emergency room complaining resting chest pain, dyspnoea, cold sweating and nausea several hours after symptoms onset. Of note, she had some risk factors for coronary artery disease. She also had been recently notified of a bereavement. On arrival, she was in pain, her vitals were heart rate 90 bpm, respiratory rate 20 rpm, blood pressure 90/60 mm Hg and O2 saturation 91%. Admission ECG is shown in figure 1. She was moved emergently to the catheterisation laboratory while being started on 300 mg aspirin, 600 mg clopidogrel, 5000 U of heparin and 80 mg atorvastatin. Soon, her blood pressure dropped to 60/40 mm Hg and she was started on vasopressors and intravenous fluid resuscitation achieving a blood pressure of 90/60 mm Hg. Coronary angiography is shown in figure 1