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A Case of Acute Myocardial Infarction with Atypical Symptoms in a Middle-Aged Male
Huang Zheng1,2, Ma Zengwen1,2, Jiang Ying3, Han Cunqiao2, Xu Shuyun1,2*
1Department of Emergency Medicine, West China Hospital, Sichuan University, P.R. China
2Emergency Department, Chengdu Shang Jin Nan Fu Hospital / Shang Jin Hospital of West China Hospital, Sichuan University, P.R. China
3Cardiovascular Medicine, Chengdu Shang Jin Nan Fu Hospital / Shang Jin Hospital of West China Hospital, Sichuan University, P.R. China
Corresponding Author: Xu Shuyun
Address: Cardiovascular Medicine, Chengdu Shang Jin Nan Fu Hospital / Shang Jin Hospital of West China Hospital, Sichuan University, Chengdu, Sichuan 611743, P.R. China.
Received date: 24 April 2026; Accepted date: 04 May 2026; Published date: 11 May 2026
Citation: Zheng H, Zengwen M, Ying J, Cunqiao H, Shuyun X. A Case of Acute Myocardial Infarction with Atypical Symptoms in a Middle-Aged Male. Asp Biomed Clin Case Rep. 2026 May 11;9(2):55-61.
Copyright © 2026 Zheng H, Zengwen M, Ying J, Cunqiao H, Shuyun X. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.
Keywords: Acute Myocardial Infarction, Middle-Aged Male, Atypical Symptoms, Abdominal Pain, Emergency Diagnosis and Treatment
Abstract
Objective: To investigate the clinical characteristics and key points of emergency diagnosis and treatment of acute myocardial infarction with atypical onset symptoms, so as to reduce the rates of misdiagnosis and missed diagnosis.
Methods: A retrospective analysis was performed on the diagnosis and treatment process of a middle-aged male patient with acute ST-segment elevation myocardial infarction who presented mainly with subxiphoid pain.
Results: A 55-year-old male patient was admitted with 3 hours of subxiphoid colic and a burning sensation after alcohol consumption, without typical chest pain. Emergency electrocardiography showed Q-wave formation and ST-segment elevation in inferior wall leads (Ⅱ, Ⅲ, aVF), consistent with acute inferior ST-segment elevation myocardial infarction. Coronary angiography revealed acute complete occlusion of the proximal right coronary artery and diffuse stenosis in the proximal and middle segments of the left anterior descending artery (maximum approximately 80%). Emergency percutaneous coronary intervention was performed, with one stent implanted in the right coronary artery. After the operation, the patient received standardized treatment, including lipid regulation, antiplatelet therapy, anticoagulation, blood glucose control, and gastric protection. The patient was discharged with an improved condition.
Conclusion: Acute myocardial infarction with abdominal pain as the main manifestation is highly prone to misdiagnosis. Routine electrocardiography and dynamic monitoring of myocardial necrosis markers in the emergency department are crucial for early diagnosis and can significantly improve patient prognosis.