Coronary heart disease is one of the most common cardiovascular diseases, which occurs in middle-aged and elderly people. It is caused by the narrowing and occlusion of the coronary arteries that supply blood to the heart due to atheromatous plaque, resulting in reduced or even partial interruption of blood supply to the heart, thus causing myocardial ischemia, hypoxia and even necrosis. Depending on the severity of ischemia, patients may suffer from angina pectoris, myocardial infarction, congestive heart failure, and even sudden death. There are more and more cases and reports about the diversity and weirdness of clinical manifestations of coronary heart patients, and the manifestations of coronary heart patients are not all the same every time they have an attack: the vast majority of patients present with a feeling of pressure and stuffiness behind the sternum, accompanied by obvious anxiety, lasting 3 to 5 minutes, sometimes with headache and toothache, and some patients can radiate to the shoulder, neck, jaw, mainly on the left side. Some patients may even be asymptomatic. Many patients have extensive coronary artery obstruction but have never felt angina, and some patients do not feel angina even during myocardial infarction. In this case, the patient had epigastric pain, which is rare and easily confused with abdominal disease. This may be related to the different sites of nerve reflexes caused by the heart attack. It may be accompanied by low-grade fever, restlessness, cold sweat, vomiting, palpitations, dizziness, extreme weakness, dyspnea, and near-death feeling for more than 30 minutes, often for several hours. This condition should be seen immediately. Therefore, especially in the elderly, it is important not to forget to have a cardiac examination for abdominal pain. Echocardiography is an important and preferred method to detect heart disease. The echocardiogram is an ultrasound probe placed in the chest wall or esophagus, which scans numerous sections of the heart in three dimensions and comprehensively analyzes the location, morphology, activity and blood flow characteristics of the heart structures, thus obtaining anatomical, physiological, pathological and hemodynamic diagnostic information of cardiovascular diseases. It is used as a test to determine cardiac function, follow-up, intervention, intraoperative and postoperative cardiac morphology and function. Ultrasonography is the only instrument that can dynamically display the structures within the heart chambers, heart beats and blood flow. It is a non-invasive examination. In recent years, the development of intraesophageal ultrasound, intravascular ultrasound, and three-dimensional cardiovascular ultrasound imaging technology has further broadened the scope of its application and greatly improved the diagnostic sensitivity and specificity.