Atypical Forms of Myocardial Infarction

Atypical myocardial infarction often occurs in older patients with a pronounced cardiosclerosis, circulatory failure, and often with people who have a history of heart attacks.

The symptoms may confuse you, or make you think that they are not associated with the heart.

Usually, atypical manifestations develop only in the initial stages of myocardial infarction. As symptoms develop, the clinical features become obvious, when the condition aggravates. 

The peripheral form of myocardial infarction with atypical localization of the pain, which occurs not in the retrosternal or precordial region behind the chest bone, but:

• in the throat (laryngeal-pharyngeal form) 
• in the left-hand end of the left little finger (left-hand form)
• left shoulder blade (left shoulder blade form) 
• in the cervical-thoracic spine (upper vertebral)
• lower jaw (mandibular form)

The intensity of pain varies. Sometimes it is enhanced, and not relieved by nitroglycerin. The rest of the symptoms are characterized by weakness, sweating, blood pressure drop, Croc's disease, palpitations, arrhythmias.

The abdominal form is usually found in posterior diaphragmatic myocardial infarction (the back of the heart). There is an intense pain in the epigastric or right upper quadrant of the stomach, the right half of the abdomen. Also. The pain is accompanied with nausea, vomiting, abdominal distention (upset stomach), paresis of the stomach and intestines, diarrhea.

On the palpation, the muscles of the anterior (front) abdominal wall are stretched. The cardiovascular system reaction includes the drop in blood pressure, voiceless heart tones, and a variety of arrhythmias.

• An arrhythmic form of myocardial infarction is characterized by the appearance of different rhythm disturbances (arrhythmias, atrial fibrillation, paroxysmal tachycardia), as well as different types of atrioventricular block (when there is an insufficient conduction of the electrical impulse through the heart wall, the pulse does not go through from the atrium to the ventriculus)
• Asthmatic form of myocardial infarction is characterized by the development of cardiac asthma and pulmonary edema (severe dyspnea, cough with frothy sputum) in the absence or weak expression of pain in the heart. A significant drop in the blood pressure, the cantering rhythm (galop) may occur as well, various arrhythmias are a weighing factor of this form of MI. This form is typical for a heart attack in the presence of severe cardiosclerosis, hypertension, and almost always develops into papillary muscles myocardial infarction. 
• Collapse form of myocardial infarction differs completely from the other forms of MI by the absence of pain. However, the clinical picture shows domination of the sharp sudden hypotension, dizziness, cold sweat, darkening of the vision. This condition is regarded to a manifestation of cardiogenic shock a severe life-threatening condition. 
• Cerebral infarction form appears as the development of a classical clinic of cerebral circulatory disorders. The distinguishing features of this condition are a headache, dizziness, nausea, vomiting, less often motor and sensory disorders. The insufficiency of cerebral blood supply occurs against a background of atherosclerotic lesions of cerebral arteries due to a decrease in cardiac output ( the heart does not pump enough blood to feed the brain, which leads to the oxygen starvation of the head), which is typical for acute myocardial infarction. 
• Edematous form of myocardial infarction, it is when the patient has shortness of breath, weakness, swelling, even an ascites. The development of the symptoms occurs relatively quickly. Also, an enlarged liver might be found while examinations as well. An acute right ventricular failure develops while this form of MI leading to the fluid effusion in the abdominal cavity (ascites). 
• Subclinical form of myocardial infarction is characterized by weakness, sweating, chest pain of uncertain nature. In general, these symptoms are difficult to interpret, as they might be found in numerous conditions.
• Combination form of myocardial infarction includes several different manifestations of atypical forms. 

For the diagnosis of atypical forms of myocardial infarction, all clinical symptoms should be carefully assessed, such as dynamic ECG changes and resorption necrotic syndrome.

Special features found in the biochemical blood test, echocardiography data have to be encountered.

If you feel that there is something wrong in your chest, and you are from the risk group according to the age and health condition, do not hesitate to call an ambulance.