Severe chest pain comes and goes

[ChrisPAinED]

So I am going to tell you a presentation of a patient I had which is usually not caught in the ED often and let you work into the diagnosis and treatment. 

 

A male patient mid 30s presents with severe chest pain explained it as tight and crushing. 

Triage: HR was in the 150s BP was something like 100/50 and O2 was normal along with RR and temp. 

HPI: 

Patient has been having really bad chest pains for about 15min every time he exercises which he recently started HIIT exercises and his quality of life had worsened so he jogged to the hospital so this time he presents he will be symptomatic since last time he went to a hospital it was brushed off has GERD. 

 

This presentation is pretty clear but the last ED he went to missed it off what investigations would you order. 

 

by the time I went into the room patient heart rate was stabilized back to normal limits