| Abstrakt: |
The typical case of myocardial infarction, with severe chest pain, drop in blood pressure, and cardiac electro-cardiographic findings is a textbook diagnosis. Further examination in such cases is usually not necessary. It is the atypical case of infarction that offers a challenge in diagnosis. By chance, one of us (J. M. K.) had occasion to examine four patients with atypical but similar cases of myocardial infarction. The similarity lay in the fact that none of the patients described the usual chest pain, but all had midabdominal pain, drop in blood pressure, and left-sided basilar pulmonary rales.REPORT OF CASESCase 1.—A 46-year-old white man complained of nausea, vomiting, diarrhea, and mild midabdominal pain. Physical examination revealed a blood pressure of 90/60 mm. Hg that at first was attributed to peripheral vascular collapse; however, there were also profuse subcrepitant basilar rales on the left that could not be explained on this |
