A 60-year-old-woman presented to the emergency department with a six-hour history of severe left pectoral chest pain radiating to left shoulder associated with shortness of breath. She noted that these symptoms improve with upright position and worsens with laying supine. Electrocardiogram and serial cardiac enzymes were normal. Chest X-ray revealed a dilated stomach protruding into the left chest (Figure 1, panel a) that was not present in chest X-ray that had been performed 3months earlier (Figure 1, panel b).
