A 34-Year-Old Man Is Being Evaluated for a 3-Month History

A 34-year-old man is being evaluated for a 3-month history of chest pain.  He describes frequent episodes of substernal squeezing-type chest discomfort that radiates to his neck.  The episodes are not related to any particular activity, often occur at rest, and last up to 2 hours.  He has no shortness of breath, wheezing, palpitations, syncope, or leg swelling.  The patient does not use tobacco, alcohol, or illicit drugs.  Family history is unremarkable.  His blood pressure is 123/72 mm Hg, and pulse is 76/min.  BMI is 32 kg/m².  ECG is normal.  Exercise stress test shows no abnormalities.  Which of the following is the most likely cause of this patient's chest pain?

A) Aortic disease
B) Coronary artery disease
C) Esophageal disease
D) Musculoskeletal disease
E) Pleural disease
F) Pulmonary hypertension

Correct Answer:

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