Mrs Patel's case shows the challenge of assessing young patients with possible cardiac chest pain.1 The location of her chest discomfort may be considered atypical, but Marin Marinovic correctly notes that the close relation with exertion raises the possibility that it is cardiac in origin.2 Overlap in the location of symptoms between patients presenting with cardiac and non-cardiac chest pain makes discrimination difficult using this factor alone.3

Several respondents on bmj.com flag the possibilities of pulmonary embolism or pneumothorax as causes of chest pain in the postnatal period.2 However, the absence of dyspnoea and the non-pleuritic …