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The final diagnosis was spontaneous coronary artery dissection (SCAD) starting in the mid LAD and continuing distally where it wraps around the apex. SCAD wasn't on my differential per se , but in retrospect it should have been. Most patients presenting with SCAD report a preceding emotional or physical stressor.
Typical angina was defined as a symptom complex that includes substernal chest pressure or pain that was made worse with exertion/emotional stress, and relieved by rest or nitroglycerin. Atypical angina is classified as having any two of the three symptoms, and non-anginal pain any one of the three symptoms.
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