A Near Miss in the Emergency Department: Atypical Presentation of Acute Coronary Syndrome

Area of Science:

• Cardiology
• Internal Medicine
• Emergency Medicine

Background:

• Acute coronary syndrome (ACS) affects millions globally, encompassing conditions like myocardial infarction (MI).
• Despite advanced diagnostics, MI diagnosis can be challenging, particularly in specific patient subgroups.
• Heart disease prevalence is higher in males and increases significantly in adults over 75.

Purpose of the Study:

• To present an atypical case of unstable angina and non-ST-elevation MI.
• To highlight diagnostic challenges in specific populations.
• To emphasize the importance of recognizing non-traditional symptoms of acute coronary syndrome.

Main Methods:

• Case report detailing an atypical presentation of acute coronary syndrome.
• Review of diagnostic modalities for myocardial infarction.
• Discussion of demographic factors influencing symptom presentation.

Main Results:

• The case illustrates a scenario where typical heart attack symptoms were absent.
• Atypical presentations were observed in subgroups including the elderly, individuals with diabetes, and females.
• Diagnostic delays can occur when relying solely on classic symptomology.

Conclusions:

• Myocardial infarction diagnosis requires vigilance for atypical presentations, especially in vulnerable populations.
• Healthcare providers must consider non-traditional symptoms to avoid missed diagnoses of ACS.
• Further research into sex-based and age-related differences in ACS presentation is warranted.