Med. praxi. 2025;22(5):316-318 | DOI: 10.36290/med.2025.052

Less common manifestations of acute myocardial infarction

MUDr. Tomáš Janota, CSc.
III. interní klinika VFN a 1. LF UK, Praha

Acute myocardial infarction has several typical manifestations that lead to further examinations necessary to confirm or exclude it. Even the lay population is educated about these manifestations. However, very often the manifestations of infarction are not typical. However, even patients without characteristic pain should not escape correct and early diagnosis. An infarction should therefore be considered even in the case of atypical pain, dyspnoea itself, nausea to vomiting, sweating attacks, palpitations, sudden general weakness to syncope, unclear anxiety, and restlessness, stroke or transient ischemic attack, sudden confusion to delirium, manifestations of peripheral arterial embolization, rarely also in diarrhea.

Keywords: acute myocardial infarction, less typical manifestations.

Received: April 14, 2025; Revised: June 8, 2025; Accepted: June 23, 2025; Published: December 1, 2025  Show citation

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Janota T. Less common manifestations of acute myocardial infarction. Med. praxi. 2025;22(5):316-318. doi: 10.36290/med.2025.052.
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References

  1. Thygesen K, Alpert JS, Jaffe AS, et al. Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618-e651. doi: 10.1161/CIR.0000000000000617. Erratum in: Circulation. 2018 Nov 13;138(20):e652. doi: 10.1161/CIR.0000000000000632. PMID: 30571511. Go to original source... Go to PubMed...
  2. Scheitz JF, Nolte CH, Laufs U, et al. Application and interpretation of high-sensitivity cardiac troponin assays in patients with acute ischemic stroke. Stroke. 2015 Apr;46(4):1132-40. doi: 10.1161/STROKEAHA.114.007858. Epub 2015 Mar 3. PMID: 25737317. Go to original source... Go to PubMed...
  3. Devon HA, Rosenfeld A, Steffen AD, et al. Sensitivity, specificity, and sex differences in symptoms reported on the 13-item acute coronary syndrome checklist. J Am Heart Assoc. 2014 Apr 2;3(2):e000586. doi: 10.1161/JAHA.113.000586. PMID: 24695650; PMCID: PMC4187491. Go to original source... Go to PubMed...
  4. Bayer AJ, Chadha JS, Farag RR, et al. Changing presentation of myocardial infarction with increasing old age. J Am Geriatr Soc. 1986 Apr;34(4):263-6. doi: 10.1111/j.1532-5415.1986.tb04221.x. PMID: 3950299. Go to original source... Go to PubMed...
  5. Jacoby RM, Nesto RW. Acute myocardial infarction in the diabetic patient: pathophysiology, clinical course and prognosis. J Am Coll Cardiol. 1992 Sep;20(3):736-44. doi: 10.1016/0735-1097(92)90033-j. PMID: 1512357. Go to original source... Go to PubMed...
  6. Brieger D, Eagle KA, Goodman SG, et al. GRACE Investigators. Acute coronary syndromes without chest pain, an underdiagnosed and undertreated high-risk group: insights from the Global Registry of Acute Coronary Events. Chest. 2004 Aug;126(2):461-9. doi: 10.1378/chest.126.2.461. PMID: 15302732. Go to original source... Go to PubMed...
  7. Fujino M, Ishihara M, Ogawa H, et al. J-MINUET Investigators. Impact of symptom presentation on in-hospital outcomes in patients with acute myocardial infarction. J Cardiol. 2017 Jul;70(1):29-34. doi: 10.1016/j.jjcc.2016.10.002. Epub 2016 Nov 14. PMID: 27856131. Go to original source... Go to PubMed...
  8. Ochiai ME, Lopes NH, Buzo CG, et al. Atypical manifestation of myocardial ischemia in the elderly. Arq Bras Cardiol. 2014 Mar;102(3):e31-3. doi: 10.5935/abc.20140025. PMID: 24714791; PMCID: PMC3987323. Go to original source... Go to PubMed...
  9. Gregoratos G. Clinical manifestations of acute myocardial infarction in older patients. Am J Geriatr Cardiol. 2001 Nov-Dec;10(6):345-7. doi: 10.1111/j.1076-7460.2001.00641.x. PMID: 11684919. Go to original source... Go to PubMed...
  10. Ferry AV, Anand A, Strachan FE, et al. Presenting Symptoms in Men and Women Diagnosed With Myocardial Infarction Using Sex-Specific Criteria. J Am Heart Assoc. 2019 Sep 3;8(17):e012307. doi: 10.1161/JAHA.119.012307. Epub 2019 Aug 20. PMID: 31431112; PMCID: PMC6755854. Go to original source... Go to PubMed...
  11. Aronow WS. Silent MI. Prevalence and prognosis in older patients diagnosed by routine electrocardiograms. Geriatrics. 2003 Jan;58(1):24-6, 36-8, 40. PMID: 12545670.




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