The trauma surgeon continued. “After the injury, patient got up without incident, developing pain along the left sternum about thirty minutes later, which he said quickly resolved. He then drove the approximate two to three hours home. Patient stated later that afternoon, he complained to his wife of a ‘hollow sensation’ in his chest that worsened with deep inhalation, and some mild shortness of breath with exertion. He presented this afternoon at the urging of his wife. On initial evaluation, he denied any nausea, vomiting, diaphoresis, back pain or fever, and was comfortable at rest. No neurologic complaints. He did note a contusion of his left lower leg from a fall on ice one week prior. No past medical history, no medications, nonsmoker, exercises regularly, and no family history of cardiac or connective tissue disease.” The other doctor scrolled through more notes on his tablet as Thad finished washing. “In triage, blood pressure was one hundred over eighty, pulse seventy, respiratory rate twenty. O-stats one hundred percent on room air, and temp ninety-nine point seven. Heart sounds normal on exam with no murmurs, lungs clear bilaterally, and no tenderness to palpation of the sternum or ribs or external signs of trauma. Abdomen non-tender. A small hematoma noted on the left calf. Neurologic examination grossly normal.”