ABSTRACT
A 19-year-old woman presented to the emergency department complaining of a 4-day history of epigastric and central chest pain. The pain was stabbing in nature and came on in waves of severe intensity. She had vomited twice and complained of odynophagia. She was very tearful and unable to give further details regarding the pain. She was a politics student and lived in university halls of residence. She smoked 10 cigarettes daily and used cocaine at the weekend. She drank around 20 units of alcohol per week, although this was typically all consumed over Friday and Saturday nights.
