患者，男，59岁。今晨看晨报时，突然出现胸骨后胸痛剧烈，并放射至左臂内侧和左手小指与无名指，含服硝酸甘油并休息40分钟后仍不缓解，送医院后急查心电图显示ST段压低≥0.1mV。该患者首先考虑诊断为

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