61 y/o M with a h/o HTN and CAD, presenting for sudden onset substernal chest pain while sitting down watching television tonight. He describes his pain as a sharp and squeezing sensation, rated a 9/10 which radiates to his L arm and jaw. He has had nausea and vomiting x1. The patient noted no improvement with drinking water at home, but upon EMS arrival he was given sublingual NTG with brief improvement before his pain returned. No reported aggravating factors. He denies having this previously and has no other concerns or complaints.