MediAI

Executive Clinical Summary “Upper abdominal pain and vomiting.” When a patient presents to the emergency department with these symptoms, gastrointestinal disease is often considered first. However, particularly in older adults and patients with diabetes or cardiovascular risk factors, these symptoms may represent an atypical presentation of acute myocardial infarction. The key lesson from this case is not simply recognizing the symptoms. It is recognizing the clinical connection between myocardial infarction and the subsequent development of left ventricular mural thrombus (LVT) . A woman in her 70s with diabetes presented to the emergency department with a 3-day history of upper abdominal pain and vomiting. Electrocardiography demonstrated normal sinus rhythm with pathological Q waves and T-wave inversions in the precordial leads, while high-sensitivity troponin was elevated to 686 ng/L. Coronary angiography subsequently demonstrated complete occlusion of the mid left anterior descend...