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Atypical chest pain with precordial T wave inversions
A 74-year-old woman with a prior history of coronary artery disease presented to the emergency department with intermittent, burning epigastric pain. Five months prior, she had a stress echocardiogram that showed no signs of ischemia. On presentation, her cardiac exam was normal, chest auscultation revealed wheezes, and the chest wall was tender. Her chest pain resolved on admission. A complete blood count, comprehensive metabolic panel, and serial troponin levels were normal. Serial 12-lead electrocardiograms (ECGs) demonstrated dynamic T wave inversions in the precordial leads, most notably in leads V2-V3 (Figure 1A-B).
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