Fitting a Square Peg in a Round Hole: A Simple Case of Chest Pain

Author:

McLean Mary1,Beck-Esmay Jennifer2

Affiliation:

1. St. John’s Riverside Hospital, Department of Emergency Medicine, Yonkers, New York

2. Mount Sinai St. Luke’s-Mt Sinai West, Department of Emergency Medicine, New York, New York

Abstract

A 39-year-old female presents to the emergency department with chest pain and shortness of breath. Her electrocardiogram suggests ST-elevation myocardial infarction, but she has no atherosclerotic risk factors. She is gravida 4, para 4, and four weeks postpartum from uncomplicated vaginal delivery. She is diaphoretic and anxious, but otherwise her exam is unremarkable. Cardiac enzymes are markedly elevated and point-of-care echocardiogram shows inferolateral hypokinesis and ejection fraction of 50%. In this clinicopathological case, we explore a classically underappreciated cause of acute coronary syndrome in healthy young women.

Publisher

Western Journal of Emergency Medicine

Subject

Emergency Nursing,Emergency Medicine

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