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.