A. Pneumothorax

B. Unstable angina

C. Pulmonary embolism

D. ST elevation myocardial infarction

E. Aortic dissection

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The correct answer is E

• Aortic dissection presents very likewise to myocardial infarction, nevertheless, the pain is classically described as tearing in nature and radiates into the back. An ECG can show ST elevation in the inferior leads if it involves the right coronary artery. In this case, the ECG did not show any ST elevation, hence, it is not an ST-elevation myocardial infarction.

• Note that, a GTN spray should provide relief within a few minutes, hence taking 20 minutes to provide light relief is unlikely in genuine vasodilatation relieving angina.

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