Acute occlusion of the LMCA without significant dynamic changes in the ECG: A case report.

Acute myocardial infarction caused by left main coronary artery (LMCA) occlusion is a critical condition with high mortality. However, when it presents with atypical symptoms and lacks dynamic electrocardiogram (ECG) changes, it poses a diagnostic challenge leading to delayed treatment and poor outcomes. This case report aims to highlight the importance of early recognition and intervention in such "double-negative" presentations to improve prognosis and reduce mortality. A 49-year-old male with no cardiac history presented to the emergency department with abdominal distension for 4 hours after ingesting a large amount of alcohol. Acute complete occlusion of the LMCA. Percutaneous coronary intervention. One Firebird 3.0 × 33 mm (MicroPort company, Shanghai China) stent was successfully implanted in the LMCA, and the stenosis disappeared and blood flow was smooth after the operation. A typical AMI without dynamic ECG changes requires aggressive diagnostic workup, including early angiography, to prevent fatal outcomes.