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A 30-year-old male with history of polysubstance use presents after a motor vehicle collision. He reports chest and leg pain, and denies nausea, vomiting, or shortness of breath. He has no known cardiac history.

View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Figure 1. Initial ECG. (Case presented by Catie Reynolds, MD, McGovern Medical School at UTHealth Houston, Department of Emergency Medicine.)
A 30-Year-Old Male with Chest and Leg Pain—and a History of Polysubstance Use