A 40-something male complains of worrisome chest pain and possible " fever "

This was sent by an EM colleague at Highland Hospital in Oakland.  His name is " Deep " A 40-something male complained of chest pain and SOB that began 2 hours prior at work and was becoming progressively worse.  He had additional nausea and vomiting and complained of fever.  The pain was constant, pressure-like, substernal, without radiation, and was 10/10 in intensity.  He stated that his wife had been diagnosed with Covid 3 months prior and that he, too, had been tested but never received the results. BP was 213/128.  Apparently no temperature was recorded as the patient looked very uncomfortable.  Temp was not recorded until much later when it was 36.5.Here was his triage ECG:There is ST Elevation that meets STEMI criteria in V2 and V3What do you think?The initial 4th generation troponin I was less than 0.010 ng/mL (undetectable).The ECG looks a lot like early repolarization because: 1. There are asymmetric T-waves (slower upstroke, faster downstroke)2. There is upward concavity in all of leads V2-V6 (in this case, even in V1)3.There is no reciprocal ST depression4.There is no terminal QRS distortion (there are S-waves in both V2 and V3)5.There are no Q-waves However, there is lots of ST Elevation, and Upright T-wave, in V1:  (In our study, Upright T-wave in V1 was found in 46% of Normals and 73% of LAD occlusion.  T-wave in V1 larger than T-wave in V6 was found in 15% of Normals and 39% of LAD occlusion.&nb...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs