Acute myocardial infarction can present with syncope and severe abdominal pain instead of typical chest pain, particularly in patients with risk factors.
Acute myocardial infarction can present atypically with syncope and abdominal pain without chest pain, requiring a high index of suspicion to avoid delayed reperfusion.
Absolute Event Rate: 0% vs 0%
Atypical presentations of acute myocardial infarction can make early diagnosis challenging, particularly when chest pain or discomfort is absent. We present a case of a 60-year-old man with diabetes, hypertension, a previous myocardial infarction (MI), and heart failure with reduced ejection fraction who presented with syncope and severe abdominal pain but no chest pain or discomfort. The ECG demonstrated an inferior ST-segment elevation myocardial infarction. He received dual antiplatelet therapy and anticoagulation before emergent transfer for coronary angiography, which revealed right coronary artery occlusion. We concluded that acute myocardial infarction can present without chest pain or discomfort and instead manifest with syncope and/or abdominal pain, especially in patients with risk factors for atypical presentations. Clinicians should maintain a high index of suspicion for acute coronary syndrome in such cases to avoid delays in diagnosis and reperfusion therapy, as delays may increase morbidity and mortality.
Ja'anini et al. (Mon,) reported a other. Acute myocardial infarction can present with syncope and severe abdominal pain instead of typical chest pain, particularly in patients with risk factors.
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