Post-Viral Chest Pain

A young woman is seen in clinic for a chief complaint of chest pain. She reports that this pain was sudden onset and had awoken her from her sleep. She had difficulty sleeping in bed cause the pain was a lot worse. Chest pain is retrosternal, sharp with no radiation. Some palliation with leaning forward. You inquired about other anginal equivalent symptoms, which were not endorsed. She has no other significant medical history nor is she on any medications. Exam only significant for an extra heart sound with a to and fro nature. Serial troponins (2x over 14-16 hours) were negative. Chest x-ray and ECG are shown below.  An example of what her echocardiogram (courtesy of wikimedia) looked like is shown below. She is concerned about this chest pain. How will you further manage? Vote using the poll below or click herenormal cxr

ATclass2i#ECGclass

Apikal4D
Courtesy of wikimedia

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