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hello my dear friends I myself dr. Rajesh Im a cardiologist and also your mentor for your need PG PG n here and as well as some aims exams and I teach journalism and Ive come to the daily dose so todays question is I have a 55 year old man he has just arrived in the accident and emergency completely twenty minutes off central crushing chest pain which features his most indicative of myocardial infarction and in this moment in time the options are inverted TVs ST depression ST elevation presence of cubes and raised chauvelin now so mainly the options given on the ECG changes and as well as the troponin C in myocardial infarction and the other important area by cardiac biomarkers are the seeing this Guardian biomarkers after two to four hours of myocardial infarction but the question given here is the individual into the accident and emergency department within 20 minutes of the onset of pain right within 20 minutes of one sort of central crushing chest pain so you release opening no