A 40-year-old woman presented with a 3-month history of recurrent left-sided chest pains. Initially, her pains were relieved by using antacids and massages. The onset of her pains usually coincided with the second or third day of her menstruation each month and usually lasted up to 4 days. Rests frequently eased her pains, hence she did not seek medical attention. In 4th month she eventually presented herself in the emergency department of my hospital . She had sudden onset sharp chest pain, 10/10 in intensity, which radiated up to her jaw and travelled down to her arms.
The pain was non-exertional and sublingual nitrates did not help. She also complained of diaphoresis, hot flushes and persistent lethargy. This presentation coincided with the second day of her menstruation. Patient is overweight and she did not have any other cardiac risk factors. Nor any of the family member has…