Pseudo-myocardial infarction pattern in a patient with spontaneous pneumomediastinum

A 24-year-old, previously healthy man was referred to our emergency department with initial diagnosis of acute coronary syndrome. He admitted to the emergency room with vomiting and sudden onset of chest pain,which arising from epigastrium, radiated to neck and shoulders beginning immedietaly after lunch. The initial examination did not show any specific finding. A baseline electrocardiogram taken at an initial hospital revealed a normal sinus rhythm with Q waves in leads V1-4.