This is a 51 year-old male with a past medical history of hypertension, hyperlipidemia, and COPD; who is presenting to the Emergency Department with chief complaint of sudden onset of sharp, radiating (chest to left arm), constant, "pressure" sub-sternal chest pain rated 6/10 in severity starting at 0630 while at rest on his couch. Associated symptoms include nausea and shortness of breath, worse on exertion. Chest pain was alleviated with NTG, which was given by EMS en route. Symptoms are aggravated with laying down and deep inspiration. Patient does not have a cardiac history, so he has never had a complete cardiac work-up in the past. Primary care provider is Dr. Nguyen. Socially, he does endorse daily tobacco use (2 cigars daily) and alcohol consumption (2-3 shots of hard liquor). He denies any illicit drug use. No know frug allergies.