A 45-year-old woman presents to the emergency department complaining of sharp, left-sided chest pain that began yesterday. She describes the sensation as “stabbing” and notes it worsens with deep inspiration and turning her torso. The pain is not associated with exertion and does not radiate. She reports recent heavy lifting while gardening two days ago. She denies fever, cough, palpitations, or leg swelling.

Her past medical history is unremarkable, and she takes no regular medications. Her father had a mild “heart attack” at age 65; he is now 74 and doing well. She has never smoked and has one to two glasses of wine on most weekend nights.

She appears comfortable at rest but winces with movement. She is afebrile. Her blood pressure is 128/76 mmHg with a heart rate of 78 bpm and oxygen saturation of 98% on room air.