P1The patient reports sudden-onset crushing substernal chest pain with radiation to the left arm, onset 45 minutes ago

P2ECG shows ST elevation of 2mm in leads II, III, and aVF

P3The AHA criterion requires ST elevation in two or more contiguous leads

P4Serum troponin I is 2.8 ng/mL against an institutional upper limit of normal of 0.04 ng/mL