Article: Chest pain in a young woman.

PRESENTATION

Ms. M, a 22-year-old African-American woman, was hospitalized because of severe substernal chest pain. The pain, which had begun to develop three months before, was diagnosed as indigestion and treated with ranitidine (Zantac). For a day she had severe substernal fullness without radiation, sweating, dyspnea, or nausea. Nitroglycerine in the emergency department did not relieve her discomfort. There was no history of diabetes mellitus, hyperlipidemia, or renal disease. She did not smoke or drink alcohol and had never used cocaine. She liked fast foods. She was taking an oral contraceptive.

Her father was in his 40s and was hypertensive. Her ...

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