A woman in her 50s with hypertension, diabetes mellitus, and coronary artery disease who underwent coronary artery bypass graft surgery 1 month prior was admitted to the hospital for right-sided chest pain of 1-day duration. The patient described the pain as sharp in nature, nonpleuritic, radiating to her right hand, and lasting for 2 to 3 min at a time. She denied cough, shortness of breath, diaphoresis, or palpitations but reported having fevers and chills 1 day prior to presentation. Her temperature was 38.7°C. Cardiac examination was normal except for mild tachycardia. No jugular venous distension was noted. The sternal incision site did not show erythema, swelling, or fluctuation, but chest wall tenderness was elicited along the right-side parasternal region of the second and third intercostal spaces. No sternal click was present. Laboratory results showed leukocytosis (17.9 × 103/μL) but otherwise normal electrolyte levels and renal function. Cardiac enzyme levels were normal, and no new ECG changes were noted. Chest radiography revealed no infiltrates, pulmonary edema, or effusions (Fig 1). Ceftriaxone was empirically initiated.