1st June 2026

Mr John Harris, a 58-year-old male, presents with retrosternal chest pain that has been ongoing for the past 3 hours. He reports a history of hypertension, hyperlipidemia, and smoking.

Mr John Harris, a 58-year-old male, presents with retrosternal chest pain that has been ongoing for the past 3 hours. He reports a history of hypertension, hyperlipidemia, and smoking. His vital signs show mild tachycardia, and his ECG reveals T-wave inversion in the anterior leads. His initial serum troponin level is 0.08 ng/mL, and a repeat sample after 2 hours shows a rise to 0.12 ng/mL (ref <0.034ng/mL). His chest pain has not completely relieved despite administration of nitroglycerin. Given his clinical presentation and troponin rise, which of the following is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.