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Orofacial Pain and Toothache as the Sole Symptom of an Acute Myocardial Infarction Entails a Major Risk of Misdiagnosis and Death
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
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2020 (English)In: Journal of Oral & Facial Pain and Headache, ISSN 2333-0384, Vol. 34, no 1, p. 53-60Article in journal (Refereed) Published
Abstract [en]

Aims: To provide an update of knowledge regarding the clinical presentation and neurophysiologic aspects of orofacial pain of cardiac origin in the form of a literature review. Methods: The peer-reviewed databases Scopus/Embase, NCBI (PubMed), and Science Direct were searched up to December 2018. Results: Patients with myocardial infarction presenting without chest pain run a higher risk of death due to missed diagnosis and subsequently a significantly greater delay between the onset of symptoms and arrival at the hospital. During myocardial ischemia, orofacial pain is reported by 4 in 10 patients and described as oppressive and/or burning. Up to 4% of myocardial infarction patients experience pain solely in the orofacial structures, women more often than men. Orofacial pain during myocardial ischemia is associated with ischemia within the inferior wall of the heart, suggesting the involvement of the vagal system. Conclusion: The clinician’s awareness of the full spectrum of clinical characteristics of a myocardial infarction constitutes a key factor in accurate diagnosis. Health care professionals and the general public should be aware of the possibility of myocardial infarction presenting with orofacial pain, toothache, or ear/temporomandibular joint pain as the only symptom.

Place, publisher, year, edition, pages
QUINTESSENCE PUBLISHING , 2020. Vol. 34, no 1, p. 53-60
Keywords [en]
cardiac ischemia, cardiac pain, myocardial infarction, orofacial pain, toothache
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-167610DOI: 10.11607/ofph.2480ISI: 000507518000006PubMedID: 31465031Scopus ID: 2-s2.0-85077943360OAI: oai:DiVA.org:umu-167610DiVA, id: diva2:1392382
Available from: 2020-02-07 Created: 2020-02-07 Last updated: 2020-02-07Bibliographically approved

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Waldenström, AndersIsberg, Annika

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Department of Public Health and Clinical MedicineDepartment of Odontology
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CiteExportLink to record
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Citation style
  • apa
  • ieee
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