Introduction: The site of acute myocardial infarction pain is in the precordial region and or posterior sternum, but there are some atypical pain sites to be alerted. It is well known that the site of acute myocardial infarction pain is in the precordial area and or posterior sternum, manifested as sudden onset of severe pain in the posterior sternum or precordial area, which may radiate to the root of the left neck, back or left upper limb, lasting for more than half an hour, and rest and sublingual or oral nitroglycerin are ineffective, often accompanied by irritability, sweating, fear or a sense of near death, not daring to continue work or activities. However, 20% to 30% of patients have atypical symptoms, and the first symptom is pain in atypical areas outside the chest, which is easy to ignore and leads to misdiagnosis or missed diagnosis. When patients with high-risk factors for acute heart attack, sudden onset of pain in these areas below should be alerted to the possibility of AMI.