Inferior MI due to RCA occlusion typically presents with which symptom besides chest pain?

• A. Epigastric pain
• B. Visual changes
• C. Hypertension
• D. Hypotension

Answer: (A)

Inferior wall myocardial infarction from right coronary artery occlusion often presents with epigastric pain due to referred visceral pain. The heart’s visceral afferents share pathways with the nerves supplying the upper abdomen, so the pain from an inferior wall MI can be felt in the epigastric region, sometimes mimicking indigestion. Nausea and vomiting can accompany this as well, reflecting vagal stimulation.

Visual changes are not typical features of RCA-only inferior MI. Hypertension isn’t a usual accompanying symptom in this context. Hypotension can occur, especially if the right ventricle is involved, but that tends to be a sign of RV infarction impacting preload and systemic perfusion rather than a common associated symptom described by patients. The most characteristic non-chest-pain symptom here is epigastric pain.