A male patient 68 years old

Previous medical history includes: Stroke, diabetes, high blood pressure

Medications: Warfarin (blood thinner), insulin, HCTZ 25 mg (blood pressure medication)

Presents today with chest pain and jaw pain that came on suddenly. His blood pressure is 174/110, sugar is 110, temperature is 98.7, and respiratory rate 22, pulse is 18. His weight is 220 and he is 5’11”.

He is in the exam room. What are you primary concerns? What would you do first?