Atypical cause of a typical chest pain

A 56 year old african american female who had a past medical history of transient ischemic attack in 2006 presented in our emergency department with first episode of sudden onset of severe central chest pain radiating to both arms , exaggerated by exertion, without any relieving factors, associated with nausea and sweating. she was taking baby aspirin, folic acid and multivitamin regularly. she did not have any history of smoking, alcohol or drug abuse.