Inpatient telemetry monitoring may be beneficial for detecting silent myocardial infarction in patients with high cardiovascular risk profiles presenting with atypical symptoms.
Isolated elbow pain may signal silent STEMI in high-risk patients; this case leaves open the spectrum of atypical presentations pending larger studies.
We report a case of silent ST-segment elevation myocardial infarction (STEMI) in a 59-year-old White man with a history of hypertension, type 1 diabetes mellitus, and stroke. He presented with an atypical symptom of left elbow pain. The patient was not experiencing chest pain. ST-segment elevation was first noted on telemetry monitoring. A 12-lead electrocardiogram confirmed ST-segment elevation in leads II, III, aVF, V5–V6, suggestive of inferolateral wall STEMI. Coronary angiography revealed a 99% subtotal thrombotic occlusion of the second obtuse marginal branch, treated with one drug-eluting stent. Inpatient telemetry monitoring may be beneficial in patients with a high cardiovascular risk profile.
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Al-Hujaily et al. (2025) studied this question.
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