A 22 year-old male with history of ventricular septal defect repaired at 2 years of age, and gastritis presents to the emergency department with a chief complaint of chest pain.
He endorses having a sore throat and other cold symptoms for the past few days that have mostly resolved by now. He reports taking some DayQuil earlier today and later drank a 24 ounce beer.
A few hours later he started to experience some substernal chest pain described as a constant pressure and occasional burning sensation with mild sweating and shortness of breath. The pain is not relieved by resting or leaning forward. He denies have any associated nausea, vomiting, reflux symptoms, or recent trauma to his chest.
An ECG and chest x-ray were obtained and are shown below:
What is the diagnosis?
How would you manage this patient?
Share your thoughts in the comments section below.
The diagnosis for this case will be posted in approximately 1 week.
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