A 54-year-old male patient arrives in the emergency department complaining of severe chest pain that radiates to his mid-back along with dyspnea. He is morbidly obese, has smoked two packs of cigarettes a day for the past 20 years, and has two immediate family members who have died of heart disease. 1. What does the ED physician suspect is causing the patient’s symptoms?

2. What tests should the ED physician order?

3. Will surgical intervention be necessary, and if so, what procedure?

4. What procedure is typically attempted before surgery, where is that procedure performed, and by what type of physician specialist?