A 34 y/o woman, with a past medical history significant
for asthma, newly diagnosed hypertension, and migraines,
presented to the emergency department with complaints
of sudden onset chest pain. She was an active young
woman, who up until the day of admission, had been able
to run several miles without chest pain or shortness of
breath. Symptoms began the morning of admission, when
the patient reported that she developed a migraine
heachache, with typical right-sided temporal pain. After
administering an injection of Sumatriptan, her headache
resolved. Soon thereafter, she noted 5/10 substernal chest
pressure occurring suddenly at rest, without radiation to
her arms or jaw. It was not associated with nausea,
vomiting, diaphoresis or shortness of breath. The patient
stated that she had never experienced this type of pain
before, which alarmed her enough to come to the
hospital. One sublingual nitroglycerin, given in the ED,
complete relieved her symptoms.