A 61-year-old woman presented to the emergency department with dyspnea and chest pain radiating to the back at rest. Laboratory tests showed creatinine 1.76 mg/dL, stable hsTnT elevation (264→256 pg/mL), NT-proBNP 19,090 pg/mL, and D-dimer 1,969 ng/mL. ECG revealed sinus rhythm with diffuse inferolateral ST-segment depression. Echocardiography demonstrated preserved…