A 72 year old presented to the emergency department having collapsed in his garden. He is accompanied by his lawyer and his son and lots of godchildren. Three other men wearing long coats and dark glasses initially accompanied the patient, although they left quickly to ‘settle some unfinished business.’ The only person who witnessed the collapse was his 4-year-old grandson, who saw him clutch his chest prior to the collapse. An ECG ( Fig. 28.1 ) was taken in the emergency department.