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Chest Pain in the Emergency Department

Question:
Benedita Bianchi de Aguiar, Tatiana Pereira, Alexandra Martins, Magalys Pereira, Miguel Costa
Department of Pediatrics, Centro Hospitalar Entre Douro e Vouga, Porto, Portugal

Address for Correspondence: Benedita Bianchi de Aguiar, Rua Marta Mesquita da Câmara 175 hab 62 4150-282, Porto, Portugal. Email beneditabaguiar@gmail.com

A 16-year-old female adolescent was brought to the emergency service due to chest and neck pain on her left side which was sudden onset, sharp and of moderate intensity. The pain worsened when she inhaled deeply. No other symptoms were described. She was previously diagnosed with an anxiety disorder and was on treatment from a psychologist and a child psychiatrist. During the physical examination, she had pain when left sternal palpation was undertaken. The pulmonary auscultation and the rest of the physical examination were normal. Her oxygen saturation was 100% at room air and she was hemodynamically stable.
Due to the physical examination as well as the medical history presented she underwent a chest x-ray and CT chest.

What is the diagnosis?