A 33-year-old man with atypical chest pain.

Moss, Alastair J; Dweck, Marc R; Flapan, Andrew D · Heart · 2017

case_report · Level V

Where this comes from

Abstract

A 33-year-old man with no history of coronary artery disease presented to the rapid access cardiology clinic with an episode of atypical anginal chest pain. He had a 15 pack-year history of smoking and a family history of myocardial infarction under the age of 55. Physical examination and exercise ECG testing were unremarkable. On assessment in the cardiology clinic, blood sampling was notable for an elevated high-sensitivity troponin I of 61 ng/L (99% upper reference level, 34 ng/L). A coronary CT angiogram was performed (figure 1). Which of the following best explains this presentation? MyocarditisMyocardial bridgingKawasaki's diseaseAtherosclerotic plaque ruptureEosinophilic coronary monoarteritis.

Medical subject headings