Case Presentation: A 47-year-old Hispanic female smoker presented with aone-week history of severe, intermittent substernal chest pain radiating tothe left arm. The pain was associated with palpitations and shortness ofbreath. She was afebrile with a heart rate of 100, a blood pressure of119/59, a fine tremor, and brisk reflexes. No lid lag or proptosis wasappreciated. [...]