Abstract
A 27-year-old lady presented to the emergency department with an acute episode of chest pain, on the background of a 6-year history of poorly controlled mixed connective tissue disease manifested by gastro-oesophageal reflux disease, digital ulceration, Raynaud’s phenomenon and interstitial lung disease (forced vital capacity 42% and diffusion capacity for carbon monoxide 27% of predicted). There were no preceding infective symptoms or fevers. Electrocardiogram demonstrated isolated non-dynamic q waves in aVL.
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