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Medical Science Monitor Basic Research


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

Unusual clinical course, Challenging differential diagnosis, Management of emergency care

Elhaitham K. Ahmed, M. Salim Alkodaymi, Mohammed Mohammed Soliman, Asaad Suliman Shujaa

Saudi Arabia Department of Medical Intern, Alfaisal University, Riyadh, Saudi Arabia

Am J Case Rep 2017; 18:1044-1047

DOI: 10.12659/AJCR.905511

Available online:

Published: 2017-09-29


BACKGROUND: Myocardial infarction (MI) is one of the most serious conditions presenting to the Emergency Department. Typical/classical symptoms of MI include chest pain and tightness that is referred to the left arm.
CASE REPORT: We present a case of ST-elevation myocardial infarction (STEMI) with a primary atypical presentation of right ear pain. The patient was diagnosed with STEMI based on electrocardiogram (ECG) and cardiac markers. As a result, the patient underwent percutaneous intervention (PCI), which showed an occluded left anterior descending artery (LAD) compared to the previous reported studies with similar presentation in which the right coronary artery (RCA) was affected.
CONCLUSIONS: While MI is known for its typical presentation, being vigilant to patients who present atypically especially when they possess risk factors is extremely important and doing so can be critical to the outcome because MI treatment is dependent on fast and prompt management.

Keywords: Earache, Myocardial Infarction, percutaneous coronary intervention