Review Question - QID 210769

A 27-year-old man presents to the emergency department for chest pain. The patient states that it has happened before, but this time it is persistent. He states that the pain started about 1 hour ago and has not been improving. The patient is a medical student and states that he is in good health. He has not been sleeping well due to his studies but otherwise says he eats a balanced diet and exercises regularly. The patient's father died of a myocardial infarction at the age of 45, and his mother currently has diabetes mellitus. The patient is not currently taking any medications. His temperature is 98.9°F (37.2°C), blood pressure is 126/68 mmHg, pulse is 119/min, respirations are 19/min, and oxygen saturation is 99% on room air. An EKG is performed as seen in Figure A. Which of the following is a potential underlying cause of this patient's chief concern?