In a small town in northern Montana, a 64-year-old retired nurse, physically active, but moderately obese, had been having episodes of angina related to physical stress for 1 week. When a more severe attack of angina persisted, she immediately chewed and swallowed 325 mg of aspirin and called her family practitioner, who arrived at her home promptly and administered 5 mg of intravenous morphine sulfate. The chest pain was alleviated soon after, and she was given 20 mg of atorvastatin and then transported by medical air ambulance 150 miles to a tertiary hospital equipped to care for acute coronary events. The admitting electrocardiogram revealed an acute ST elevation anterolateral infarction with several multifocal ventricular premature beats and a heart rate of 100 beats/minute. The duration of the acute myocardial infarction (MI) (from onset of chest pain to arrival at...

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