Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 64 1 2026 02 18 11225 11225 Salehe Mehrafarid Department of Emergency Medicine, Birjand University of Medical Sciences, Birjand, Iran. Farid Reza Ejlali Department of General Practitioner, Faculty of Medicine Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran Hanieh Amani Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Maryam Mohammadi Emergency Medicine Specialist, Mehrgan Hospital, Kerman, Iran Seyed Reza Habibzadeh Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mahdi Foroughian Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2024 08 30 2025 07 29 Acute myocardial infarction (AMI) typically presents with retrosternal chest pain exacerbated by exertion and relieved by rest or nitroglycerin. However, this case describes an 81-year-old male who presented with Diarrhea and generalized weakness, an unusual manifestation of AMI. This highlights the importance of recognizing atypical symptoms, particularly in elderly patients with comorbidities, to ensure timely diagnosis and intervention. https://acta.tums.ac.ir/index.php/acta/article/view/11225 https://acta.tums.ac.ir/index.php/acta/article/download/11225/6012