Atypical Chest Pain

Author: Catriona J Thompson / Editor: Yasmin Sultan / Reviewer: Chris Wearmouth, Shakeel Siddiqui / Codes:  CP1, CP3, SLO1, SLO2 / Published: 09/11/2020 / Reviewed: 04/10/2025

A 19-year-old male presents to the emergency department (ED) with a 24 hour history of chest pain. The pain is described as dull, diffuse across the chest, with no radiation. The patient is normally fit and well with no past medical history or significant family history. He denies any recent cough, drug use or potential mechanical explanation for the pain.

On further questioning it is evident the patient has experienced chest pain intermittently for at least 2 years but less severe, as well as occasional episodes of palpitations. An ECG is taken which is shown below.