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 Best of Five 2.65

 

   

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BOF: 2.65

A 26year old female presents with sudden onset of retrosternal chest pain. On direct questioning she reveals that the pain came on shortly after smoking marijuana.

On examination she has a pulse rate of 110 beats per minute, BP 110/60, JVP not elevated, trachea midline, apex not displaced.

On auscultation a crunching sound is heard in systole.

Respiratory and abdominal examination is unremarkable.

No abnormality is seen on the plain x-ray of her chest, ECG shows T inversion in the anterior chest leads.

Which of the following investigations is likely to confirm your diagnosis?

a)      Coronary angiogram

b)      Upper gastrointestinal endoscopy

c)      VQ scan

d)      Chest CT scan

e)      Gastograffin swallow

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