A 40-year-old man presents with severe chest pain that started while he was at rest. He was initially suspected to have an acute coronary syndrome, but his ECG and cardiac enzymes were normal. What could be the diagnosis?
Despite a clear cardiac history and the presence of severe chest pain, the normal ECG and cardiac enzymes make acute coronary syndrome less likely. One possible diagnosis could be aortic dissection, which can present with severe chest pain but without the ECG changes seen in ACS. This is a life-threatening condition in which the inner layer of the aorta tears. An aortic dissection can be confirmed by imaging, such as a CT scan.