Diagnosis: Where do chest pains and wheals come from after a walk?

A woman has chest pains, circulatory problems, and red wheals. What does a walk have to do with it? The first thing to do is clear up a bad suspicion.

Recorded by Astrid Viciano

It was an unusually cold spring day in April when the patient arrived at the emergency room at our University Hospital in Toronto. She felt nauseous, she complained of circulatory problems, her skin itched and was red. We quickly found out that her pulse was much too fast at 120 beats per minute, while her blood pressure was much too low. She also had difficulty breathing and soon began to complain of chest pains. A colleague of mine excitedly called me because her electrocardiogram (ECG) didn’t match the patient at all. She was in her twenties, slim and had no previous illnesses. But her EKG showed typical signs of a heart attack!

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