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25-year-old man with chest pain
  1. Dhara Singh1,
  2. Rachana Bhat2,
  3. Shyam S Kothari1
  1. 1 Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  2. 2 Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Shyam S Kothari, Department of Cardiology, All India Institute of Medical Sciences Ansari Nagar, New Delhi 110029, India; kothariss{at}


Clinical introduction A 25-year-old man presented with complaints of acute-onset chest pain for 2 hours associated with diaphoresis and generalised weakness. He had history of smoking for 10 years. There was no history of hypertension, diabetes, family history of premature coronary artery disease or drug abuse. On evaluation, his heart rate was 76/min, blood pressure 130/90 mm Hg and oxygen saturation 97% on room air. Cardiovascular examination was normal. The ECG is shown in figure 1.

Question What is the most likely diagnosis?

  1. Hyperkalaemia

  2. Acute myocardial infarction

  3. Early repolarisation syndrome

  4. Athlete heart syndrome


  • acute myocardial infarction
  • acute coronary syndromes

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  • Contributors All three authors are responsible for patient management. Literature was reviewed by DS and RB. Manuscript was drafted by SSK.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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