FCEM2-0189
A 35-year-old male presents to the emergency department complaining of gradual onset sharp chest pain over the past 24 hours. The patient reports that the pain worsens with deep inspiration and feels more comfortable when sitting leaning forward. When asked about pain radiation, the patient confirms that the pain extends to the left side of the neck and points to the ridge of the trapezius. Physical examination reveals clear lung fields, regular rhythm with quiet heart sounds, and no murmurs. The patient’s vital signs are as follows:
Blood pressure: 108/66 mmHg
Pulse rate: 94 bpm
Respiratory rate: 18 rpm
Temperature: 37.3ºC
Oxygen saturations: 97% on room air
What is the most likely diagnosis?