I coaxed my dad into going to the ER via phone (I am in Michigan and he is in Florida). He told me that he was sitting and eating lunch when he had a pretty intense pain behind his sternum accompanied by really intense ear pain and headache in brow area. Intense pain only lasted a short while and afterward his sternum was still quite sore as well as his upper back in the same general area. My dad has a-fib treated with digoxin, and HTN treated with metoprolol, had mitral valve replacement and is on coumadin. Also DMII well controlled A1C always below 7. He is 79 y/o. Very active was just at my house for a month and I had a hard time keeping up with him doing yard work every day. Also has rheumatoid arthritis. After all that my question is there any other possibilities besides a heart attack that produce pain in sternum and ear?