<s>[INST] My son was on a flight from cabo mexico and they had to turn around and take him back due to severe chest pain and shortness of breath, In some type of hospital now ekg normal but enzymes high,  This facility not equiped for any extensive treatment  what now? [/INST] Hi, Thanks for writing to Chat Doctor, I am Chat Doctor. ECG cannot pick MI all times . sometimes it can miss n this y we need other test to confirm it is MI . If it is infraction n there is no facility for PCI m there is hospital nearby u can reach about before 90 min it is better to take standard protocol of ACS n ten rush to that hosp to have c.Anglo n PCI if necessary . But if is not possible then thrombosed there n shift to hosp have PCI facility ...if I were your attending at that moment I would make sure it is ACS BCS myocarditis also have same features ... I hope this answered your question, if you have more feel free to ask. Regards. </s>