Chronic ischemia in Left anterior descending artery territory presenting as intractable hiccups: An unusual symptom of coronary artery disease.

Classical symptoms of ischemic heart disease include exertional chest pain associated diaphoresis, palpitations or shortness of breath. Yet, it can also present unusually with symptoms ranging from epigastric discomfort, fatigue and vomiting. A 48 years old male presented to the hospital with severe retrosternal chest pain for 6 hours duration. ECG showed acute anterior wall STEMI. Primary PCI to LAD was performed successfully. He had been complaining of intractable hiccups for the past one year for which he had been seen in gastroenterology clinics multiple times with no relief in hiccups. After we performed primary PCI to LAD, he had complete resolution of hiccups. He is still under regular follow up with us for the past 4 months with no active complaints of hiccups. This case conclude that Intractable hiccups can be the only symptomatic manifestation of coronary artery disease (CAD) in some patients. Therefore, a high suspicion of CAD should be kept in mind especially in patients with risk factors for CAD.