Detection of orofacial pain of cardiac origin due to coronary artery disease: A case report and literature review

Abstract

Abstract Background. When diagnosing orofacial pain, clinicians should also consider non-odontogenic origin and systemic diseases as possible etiological factors, along with odontogenic origin. This case report aimed to provide information for early detection of orofacial pain of cardiac origin by dentists, when pain due to coronary artery disease is the only presenting symptom. Case Presentation. A 60-year-old male patient with unexplained isolated bilateral jaw pain was referred to a dentist by an anesthesiologist whosuspected temporomandibular joint disorder. Oral examination and radiography of the temporomandibular joints revealed no bony abnormalities. Eventually, the patient was referred to a cardiologist for further evaluation since his pain was induced by physical activity. Coronary artery disease (CAD) was diagnosed using coronary computed tomographyangiography, and the pain was considered to be angina pectoris. Percutaneous coronary intervention was successfully done for the patient, after which his orofacial symptoms disappeared. Conclusions. Isolated craniofacial pain of cardiac origin may lead to patients seeking dental care or visiting orofacial pain clinics. In these settings, dentists and orofacial pain specialists may contribute to the diagnosis of CAD and refer patients for cardiac evaluation and appropriate management.