Headache: An unusual presentation of acute myocardial infrac
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Introduction:
Atypical symptoms of myocardial infarction may delay the diagnosis, and therefore the proper management to rescue ischemic myocardium. Headache represents a rare symptom of myocardial ischemia[1-5]. We report a patient with ST-segment elevation acute myocardial infarction who presented to the emergency department complaining of headache without chest discomfort.

Case:
An 86-year-old man with a history of hypertension and tobacco use presented to the emergency department complaining of recent onset severe occipital headache. The patient did not report any chest pain, dyspnea, or other typical symptoms of angina. On admission the patient was pale with tachycardia (100 beats/min), and, while his blood pressure was within normal range (100/60 mmHg). At auscultation, a mild systolic murmur was audible. The electrocardiogram (ECG) showed sinus bradycardia, ST-segment depression in leads V1-V5 and ST-segment elevation in posterior leads (V7-V9) (Figure ?(Figure1).1). Transthoracic echocardiography revealed an impaired left ventricular ejection fraction (40%-45%) along with mild mitral valve regurgitation. Initial laboratory examinations showed elevated levels of high-sensitivity cardiac troponin T (250 ng/L). Due to his clinical presentation, a brain computed tomography (CT) imaging was immediately performed....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4072842/
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