A 68-year-old woman has had mild stable angina for 5 years. She is presenting to the Emergency Department following an episode of palpitation, that she describes as a sensation of “her heart racing” for about 30 minutes. Her symptoms had subsided before arrival:

• Severe muscle motion artifacts, may adversely affect the interpretation
• Sinus rhythm
• Non-specific T wave abnormality
• Consider possible anterior ischemia