ABSTRACT
A 27-year-old woman presented to the emergency department complaining of central chest pain and feeling light-headed. The pain came on gradually around 36 hours ago and had become severe over the past 12 hours. It was a tearing pain that radiated down to the patient's upper abdomen and was worsened by deep inspiration. She denied nausea, vomiting or diaphoresis. She stated that she had been well recently, with no symptoms of fever or cough. Her past medical history included hay fever and eczema. She took no regular medications. She smoked 20 cigarettes daily but denied regular alcohol intake or recreational drug use. She worked as a historian and had not travelled abroad for more than 2 years.
