During your initial assessment she is rubbing her mid-chest, grimacing and is diaphoretic. The pain has been occurring intermittently throughout the evening and night. Her color is pale except around her lips which are bluish. Cardiac auscultation reveals a rapid regular rhythm and a murmur. She has never had this pain before. Lungs sounds are crackles in both bases with clear upper lobes. She is afraid she is going to die.