A healthy 44-year-old woman with no known cardiovascular risk factors and 2 prior presentations for typical chest pain presented to the Emergency Department with acute-onset chest pain of 4 hours duration. She had a 3-month history of typical angina-type chest pain and had been unable to exercise due to these symptoms. Her initial electrocardiogram revealed no acute ischemic changes. A diagnosis of acute anxiety was made and it was felt that an acute coronary syndrome was unlikely. Serial electrocardiograms, however, demonstrated dynamic ST-T changes in the anterolateral leads, and 12-hour troponin was found to be elevated at 14.2 ng/mL (normal range: 0.20-0.32).
To read this article in its entirety please visit our website.
-Aleem Azal Ali, BSc, MBBSa, Dayna Lalchansingh, BSc, MBBSa, Ronan George Ali, MBBS, FACP, FACC, FSCAIb,c, Tricia Ann Cummings, MBBS (Barts), FRCP (London), FACC, FESCb
This article originally appeared in the July 2019 issue of The American Journal of Medicine.
