Transient Prominent Anterior QRS Forces (PAF) in the setting of Acute Myocardial infarction – which is the mechanism

The patient is a 51 year-old gentleman with a potential history of coronary artery disease (CAD) in the past, who had undergone a stress test approximately 3 years ago while living in Brazil. The patient has been visiting the United States and after a few days began developing chest discomfort with shortness of breath on exertion as well as chest pressure. The symptoms got worse and he proceeded to the Emergency Department