A 22 year old man presents to your ED with 5 hours of central and left sided chest pain, radiating to his left arm.

Vital Signs:

BP 110/70

PR  120/min

RR 30/min

O2 Sats 100% RAVBG

ph  7.60

pO2  43mmHg

pCO2  19mmHg

HCO3  19mmol/l

BE 0

Na  140mmol/l

K  2.9mmol/l

Cl  107mmol/l

Creat  96umol/l

Glucose  6.4

Lactate  4.1mmol/l

Describe and interpret the blood test

Give a differential diagnosis