13th March 2024

A 32-year-old woman is referred to ED by her GP after presenting with a 5-hour history of upper abdominal pain radiating to her back.

A 32-year-old woman is referred to ED by her GP after presenting with a 5-hour history of upper abdominal pain radiating to her back. She is hypertensive on her initial observations, with a blood pressure of 195/102 mmHg on her right arm. On examination she has pectus excavatum and tenderness on palpation in the epigastric region. You request a blood pressure reading of her left arm while you check her GP records for her past medical history. This is significant for a spontaneous pneumothorax five years ago. Given the likely diagnosis, which is the most important investigation to confirm the pathology?

Select the SINGLE most appropriate option from the list below. Select ONE option only.