28-year-old woman with no significant past medical history presented with acute onset of sub-sternal chest pain at work. It was “pinching” type and got worse on deep breathing, coughing, leaning forward and drinking water. The pain was radiating to the back. She did not have any similar previous episodes. No recent strenuous workout including swimming, valsalva or other physical activity or trauma was reported. Her blood pressure was 135/80 mmHg; pulse 53/minute; respiratory rate 16/minute; temperature 98.2°F and oxygen saturation was 98% on room air.
