Angina and myocardial infarction presenting with pain confined to the ear
1Department of Medicine, Falkirk and District Royal Infirmary, UK.
Postgraduate Medical Journal
|April 1, 1993
Insights
Cardiac ischemia can manifest as ear pain, a rare symptom that may delay diagnosis. This atypical presentation of angina and myocardial infarction highlights the importance of considering cardiac causes for ear pain.
Area of Science:
- Cardiology
- Neurology
Background:
- Cardiac ischemia, including angina and myocardial infarction, typically presents with chest pain.
- Atypical presentations can lead to diagnostic delays and suboptimal patient outcomes.
Observation:
- Two cases are presented where cardiac ischemia manifested solely as ear pain.
- In both instances, the ear pain was initially misdiagnosed, leading to delayed appropriate treatment.
Findings:
- Ear pain can be a referred symptom of cardiac ischemia, mediated by the vagus nerve.
- This presentation underscores the variability of pain referral patterns in cardiovascular emergencies.
Implications:
- Clinicians should consider cardiac ischemia in patients presenting with unexplained ear pain, even without typical cardiac symptoms.
- Awareness of this atypical presentation can improve early diagnosis and management of myocardial infarction and angina, potentially saving lives.
Abstract:
Two cases are described in which cardiac ischemia presented with pain confined to the ear. In both cases the correct diagnosis was missed and treatment delayed. Angina and myocardial infarction may present with pain in the ear due to referral via the vagus nerve.
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