title: Craniofacial Pain as the Sole Sign of Prodromal Angina and Acute Coronary Syndrome: A Review and Report of a Rare Case.
abstract: Orofacial pain can arise from different regions and etiologies. Some of the most debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). The problem with referred pain is the misdiagnosis and unnecessary therapy directed to the pain location instead of its origin. When craniofacial pain is the sole sign of myocardial ischemia, failure to recognize its cardiac source can endanger the patient. In particular, apart from unnecessary dental treatments, patients with acute myocardial infarction who do not experience chest pain run a very high risk of misdiagnosis and death. As endodontists, each of us may face many patients complaining of pain sensation in the teeth with the main source being other craniofacial/visceral organs. This review plots a diagnostically challenging case paving the way for further literature presentation in this regard. The aim of this compendious review was to gain knowledge about the prevalence, clinical characteristics and possible mechanisms of craniofacial pain of cardiac origin, in order to improve the clinician's ability to make a correct diagnosis.
authors.affiliation: Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran; ; Department of Endodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran;
authors.forename: Mahta
authors.initials: M
authors.lastname: Fazlyab
authors.affiliation: Department of Endodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran;
authors.forename: Ehsan
authors.initials: E
authors.lastname: Esnaashari
authors.affiliation: Dentist, Tehran, Iran;
authors.forename: Mojgan
authors.initials: M
authors.lastname: Saleh
authors.affiliation: Interventional Cardiologist, Shahid Rajaie Cardiovascular, Medical and Research Center, Tehran, Iran;
authors.forename: Farshad
authors.initials: F
authors.lastname: Shakerian
authors.affiliation: Interventional Cardiologist, Head of Cardiac Catheterization Laboratory, Pars Hospital, Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Akhlagh Moayed
authors.affiliation: Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
authors.forename: Saeed
authors.initials: S
authors.lastname: Asgary
keywords: Craniofacial Pain; Myocardial Infarction; Orofacial Pain; Pre-Infarction Angina; Prodromal Angina; Referred Pain