Which of the Following Is the Primary Cause of St-segment Elevation in This Patient

Mr. Santos, a 55-year-old Male, Presents to the Emergency Department with Chest Pain Radiating to His Left Arm. He Has a History of Hypertension and Smoking. His Blood Pressure Is 160/100 Mmhg, Heart Rate Is 90 Beats Per Minute and Respiratory Rate Is 18 Breaths Per Minute. ECG Shows St-segment Elevation in Leads II, III and Avf. Troponin Levels Are Elevated