AbstractA 19 years old female came to ED with c/o chest pain with uneasiness, intermittent sweating, epigastric pain and weakness since one day. Patient had no any pre-existing comorbidity and not on any regular medication. On examination Patient was in shock haemodynamically with ECG showed normal sinus rhythm. 2D echo suggested global hypokinesia with LVEF 30%. Ultrasound whole abdomen revealed Gall Bladder wall edema with small amount of free fluid in peritoneal cavity. X-ray chest suggested B/L ground glass opacities with mild B/L pleural effusion.