Inferior ST-Segment Elevation Myocardial Infarction Presenting as Isolated Elbow Pain: A Case Report.

Acute coronary syndromes typically present with chest pain; however, atypical presentations without chest discomfort are not uncommon and may pose significant diagnostic challenges. We report the case of a 60-year-old man who presented to the emergency department with isolated left elbow pain, without chest pain or other typical symptoms. Initial evaluation revealed normal vital signs, and the clinical presentation was suggestive of a musculoskeletal condition. Due to persistence of symptoms, further evaluation was performed approximately three hours after presentation to the emergency department. An electrocardiogram was obtained at that time. Electrocardiography demonstrated ST-segment elevation in the inferior leads (II, III, and aVF), consistent with acute myocardial infarction. Laboratory testing subsequently revealed elevated high-sensitivity troponin I (244 ng/L; reference range 0-34.2 ng/L). A diagnosis of inferior ST-segment elevation myocardial infarction was established. The patient was admitted to the coronary care unit for definitive management. Further details regarding coronary angiography and revascularization were not available. Outcome data following hospitalization were not available. This case highlights the diagnostic challenges associated with atypical presentations of myocardial infarction and underscores the importance of maintaining a low threshold for electrocardiographic evaluation, even in the absence of chest pain.