Case History/examination:
A 29-year-old Colombian woman with a history of an unknown congenital cardiac condition, with a high suspicion for coarctation of the aorta that was surgically corrected for artery narrowing as a neonate in Colombia, presented to the emergency department with chest pain. The chest pain was sudden onset, dull and squeezing in nature that localized to the mid-sternum that radiates to the right side of her neck and right arm. It started while she was at rest in a seated position that lasted for 15 minutes before self-resolving associated with cramping, numbness and tingling. There were no exacerbating or relieving factors. She has never experienced the same or similar type of chest pain in the past. The patient denied fevers, cough, orthopnea, paroxysmal nocturnal dyspnea, nausea, vomiting, diaphoresis, swelling, abdominal pain, sick contacts, or significant emotional stressors. She was not taking any medications or supplements at home. She denied current or previous tobacco, alcohol, caffeine, energy drink and illicit drug use. There was no known family history of cardiac disease.
Patient’s vital signs on admission were blood pressure of 106/73 mm Hg, pulse of 76 beats per minute, afebrile, and breathing comfortably on room air. Physical examination was unrevealing.