ST-Elevation Myocardial Infarction Due to Left Anterior Descending Artery Occlusion Presenting Primarily with Otalgia

Ahmed, Elhaitham K.; Alkodaymi, Mohamad Salim; Soliman, Mervat M.; Shujaa, Asaad

doi:10.12659/ajcr.905511

Cited by 2 publications

(1 citation statement)

References 8 publications

(17 reference statements)

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“…Craniofacial pain is the sole presenting symptom in 6% of patients with an ischemic cardiac event, and it is 4 times more frequent than stomach and back pain [ 5 ]. Craniofacial pain is a referred pain from the afferent vagal nerve of the heart to efferent somatic nerves to the head and neck [ 5 , 6 ]. It is also more prevalent in women than in men.…”

Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Acute Coronary Syndrome and Importance of Wellens’ Syndrome

et al. 2018

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Patient: Female, 74Final Diagnosis: Acute coronary syndromeSymptoms: Throat painMedication: —Clinical Procedure: Percutaneous coronary interventionSpecialty: CardiologyObjective:Challenging differential diagnosisBackground:Acute coronary syndrome (ACS) is a common and potentially life-threatening condition encountered in emergency departments. Despite its dreaded nature, nearly one-third of ACS present without chest pain and may mislead clinicians. Additionally, Wellens’ syndrome is a pre-infarction stage of significant proximal left anterior descending (LAD) artery stenosis, which can lead to extensive anterior wall myocardial infarction without timely intervention.Case Report:We report the case of a 74-year-old woman presenting with isolated throat pain and Wellens’ pattern in the initial EKG, which prompted the proper workup and management. Subsequently, coronary angiogram revealed more than 90% occlusion of the proximal LAD artery, and a drug-eluting stent was deployed. The patient did well after the procedure and the follow-up at 2 weeks after discharge was uneventful.Conclusions:This case highlights the importance of awareness of atypical presentation of ACS and importance of Wellens’ syndrome. We also discuss the incidence of craniofacial symptoms of ACS, and the epidemiology, pathophysiology, management, and prognosis of Wellens’ syndrome.

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Section: Discussionmentioning

confidence: 99%

Atypical Presentation of Acute Coronary Syndrome and Importance of Wellens’ Syndrome

et al. 2018

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Atypical Presentations of Myocardial Infarction: A Systematic Review of Case Reports

Khan¹,

Karim²,

Panda³

et al. 2023

Cureus

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There is a rising incidence of coronary artery diseases and myocardial infarction (MI). Mortality associated with acute MI (AMI) is directly linked to the time to receive treatment and missed diagnoses. Although health professionals are aware of typical AMI presentation, atypical MI is difficult to diagnose, which on the other hand, is likely to have an impact on morbidity and mortality. Therefore, it is prudent to know such atypical presentations, especially for emergency and primary care physicians. We aimed to systematically evaluate the clinical presentations of atypical MI and analyze them to characterize the common clinical presentations of atypical MI. We researched the PubMed database, did citation tracking, and performed Google Scholar advanced search to find the cases reported on the atypical presentation of MI published from January 2000 to September 2022. Articles of all languages were included; Google Translate was used to translate articles published in languages other than English. A total of 496 (56 PubMed articles, 340 citations from included PubMed articles, and 100 articles from Google Scholar advanced search) were screened; 52 case reports were evaluated, and their data were analyzed. Atypical presentations of myocardial infarction are vast; patients may have chest pain without typical characteristics of angina pain or may not have chest pain. No typical characterization could be done. Most patients were in their fifth decade or above of their life and commonly presented with pain and discomfort in the abdomen, head, and neck regions. Prodromal symptoms were consistent findings, and many patients had two to three comorbidities out of four common comorbidities, i.e., diabetes, hypertension, dyslipidemia, and substance abuse. A patient who is 50 years old or more, having comorbidities such as diabetes, hypertension, dyslipidemia, history of tobacco or marijuana usage, presenting with prodromal symptoms like shortness of breath, dizziness, fatigue, syncope, gastrointestinal discomfort or head/neck pain should be suspected for atypical MI.

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ST-Elevation Myocardial Infarction Due to Left Anterior Descending Artery Occlusion Presenting Primarily with Otalgia

Cited by 2 publications

References 8 publications

Atypical Presentation of Acute Coronary Syndrome and Importance of Wellens’ Syndrome

Atypical Presentation of Acute Coronary Syndrome and Importance of Wellens’ Syndrome

Atypical Presentations of Myocardial Infarction: A Systematic Review of Case Reports

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