“Beware of Burp†: Unusual Presentation of Inferior Wall Myocardial Infarction

Central chest pain and discomfort are the most common symptoms of a patient with acute coronary syndrome. Diaphoresis, dizziness, shortness of breath, fatigability and nausea have been described as angina “equivalents”. Acute coronary syndrome can at times manifest with atypical symptoms like hiccups, belching, pharyngeal pain etc., which can mislead both the patient and the clinician. We report an unusual case of inferior wall ST elevation myocardial infarction where the patient experienced abnormal belching that brought him to a physician and a routine ECG showed ST elevation in inferior leads. Coronary angiogram showed near-total occlusion of left anterior descending and right coronary arteries. He recovered well with percutaneous coronary intervention.