A new paradigm for lipid-lowering therapy involves early initiation of upfront statin and ezetimibe combination therapy for patents at high or very high risk of cardiovascular disease. Because there is now substantial evidence for this strategy, it has been included in recent guidelines for lipid-lowering therapy in this population.
A 42-year-old man presents with a week of palpitations associated with brief sharp left-sided chest pains. He has no cardiac history, takes no medications and examination is normal apart from slight elbow tenderness. What does his ECG show, and what are the possible causes of his symptoms?
