A Cardiac Conundrum

Author: Tamsin Harvey, Faisal Faruqi / Editor: Nick Tilbury / Codes: / Published: 28/04/2022

A 47-year-old female attends the Emergency Department (ED) due to several months of intermittent, heavy pain across the centre of her chest and both shoulders. The pain occurs on moderate exertion like walking up hills or a flight of stairs and settles within 5 minutes of stopping. She has no pain at rest. There is no associated shortness of breath.

She has no significant past medical history and no family history of cardiac disease or venous thromboembolism.

She appears well at rest. Examination is completely normal. ECG shows a normal sinus rhythm with no ischaemic changes.

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