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61-year-old male. Type 2 diabetes, hypertension, former smoker. Aspirin intolerance listed as "stomach upset" (no hives or wheezing). Hemorrhoid bleeding 3 years ago, none since. Home meds: metformin, lisinopril, sildenafil 100 mg as needed.61歲男性。第2型糖尿病、高血壓、曾吸菸。阿斯匹靈不耐受列為「胃部不適」（無蕁麻疹或喘鳴）。3年前有痔瘡出血史，此後無。居家藥物：二甲雙胍、賴諾普利、西地那非 100 毫克（需要時服用）。
0740: BP 138/84 mm Hg, HR 72/min regular, RR 18/min, SpO2 96% on room air, T 36.8 C. Weight 88 kg.0740：血壓 138/84 mmHg，心率 72次/分，規律，呼吸頻率 18次/分，室內空氣下血氧飽和度 96%，體溫 36.8°C。體重 88 公斤。
0745: High-sensitivity troponin I elevated. Platelets 162,000/mm3. Hemoglobin 13.1 g/dL. Creatinine 1.3 mg/dL (baseline 1.2). Glucose 188 mg/dL. Potassium 4.4 mmol/L.0745：高敏感度肌鈣蛋白I升高。血小板 162,000/mm3。血紅素 13.1 g/dL。肌酸酐 1.3 mg/dL（基準值 1.2）。血糖 188 mg/dL。鉀 4.4 mmol/L。
Aspirin 324 mg chewed now. Nitroglycerin 0.4 mg SL every 5 min up to 3 doses PRN chest pain. Heparin IV bolus and infusion per ACS weight-based protocol. Metoprolol tartrate 25 mg PO now. Hold metformin.阿斯匹靈 324 毫克，立即口嚼服用。硝酸甘油 0.4 毫克，舌下含服，每5分鐘一次，最多3劑，需要時用於胸痛。肝素靜脈推注和輸注，依急性冠狀動脈症候群（ACS）體重計算處置規範。酒石酸美托洛爾 25 毫克，立即口服。暫停二甲雙胍。
0735: Substernal pressure since 0630, 7/10. ECG: ST elevation in leads II, III, aVF; no ST elevation in right-sided leads. Lungs clear. Spouse reports the client took his "bedroom pill" at 2200 last night; bottle confirms sildenafil.0735：自0630起胸骨下壓力，疼痛程度7/10。心電圖：導程II、III、aVF有ST段上升；右側導程無ST段上升。肺部清澈。配偶報告個案昨晚2200服用其「助性藥物」；藥瓶確認為西地那非。