]> 2026-07-31T11:51:54+00:00 WBR0527 0 en Myocardial rupture Myocardial infarction Esophageal rupture Aspiration pneumonia Acute gastritis Emergency Room A 60 yr old male is brought to the emergency department. He complains of vomiting and chest pain. He says his symptoms started 2 hours ago when he was in a party with his friends. He says he was drinking heavily and had a fight with his friend. He vomited twice before the onset of chest pain and is worsening over the 2 hour. The pain is radiating to the shoulders and is of 6/10 on severity scale. His chest pain is aggravated on deep inspiration. He denies any abdominal pain, bloody vomit, dizziness and black stools. His is a known coronary heart disease patient and on medications for that. Otherwise his past history is insignificant. His father died of myocardial infarction at the age of 60. He occasionally smokes and drinks heavily when he is with his friends. On examination pulse is 110/min, BP is 100/60 mmHg and SpO2 is 94%. Chest examination reveals S3, decreased breath sounds and dullness on percussion on left side. Abdomen is mildly distended and there is epigastric tenderness. What is the most likely diagnosis? C Gastrointestinal 2020-10-28T00:51:49Z 2459150.5359838 WBR0527