title: Craniofacial pain of cardiac origin is associated with inferior wall ischemia.
abstract: OBJECTIVE
  To investigate possible associations between the presence of craniofacial pain of cardiac origin and the location of cardiac ischemia and conventional risk factors.
  
  
  METHODS
  A total of 326 consecutive patients with confirmed myocardial ischemia (192 males, 134 females, mean age 64 years) were studied. Demographic details, health history, factors, prodromal symptoms, electrocardiogram (ECG) findings, and pain characteristics during the ischemic episode were assessed. The location of the ischemia according to the ECG findings was categorized as anterior, inferior, or lateral. Univariate chi-square analyses and a multivariate logistic regression model were used for data analysis. Two age subgroups (< 65 and > 65) were established when controlling for covariates.
  
  
  RESULTS
  Craniofacial pain of cardiac origin was significantly associated with an inferior localization of cardiac ischemia (P < .001) and was more frequently reported in diabetic patients (P = .014). Thirty-eight patients (12%) did not experience chest pain during the myocardial ischemia. Nine patients (3%) experienced a prodromal angina episode without chest pain.
  
  
  CONCLUSIONS
  The occurrence of craniofacial pain during myocardial ischemia, with or without an acute myocardial infarction, was associated with ischemia within the inferior wall. This result suggests the involvement of the vagal afferent system in the mechanisms of craniofacial pain of cardiac origin.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Kreiner
authors.forename: Ramón
authors.initials: R
authors.lastname: Alvarez
authors.forename: Anders
authors.initials: A
authors.lastname: Waldenström
authors.forename: Virginia
authors.initials: V
authors.lastname: Michelis
authors.forename: Rosana
authors.initials: R
authors.lastname: Muñiz
authors.forename: Annika
authors.initials: A
authors.lastname: Isberg
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000150:complications; D048909:Diabetes Complications; D004562:Electrocardiography / Q000379:methods; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications*; D053591:Referred Pain / Q000209:etiology; D012307:Risk Factors; D012737:Sex Factors; D014630:Vagus Nerve / Q000503:physiopathology