Toothache of cardiac origin

Pain referred to the orofacial structures can sometimes be a diagnostic cha llenge for the clinician. In some instances, a patient may complain of toot h pain that is completely unrelated to any dental source. This poses a diag nostic and therapeutic problem for the dentist. Cardiac pain most commonly radiates to the left arm, shoulder, neck, and face. In rare instances, angi na pectoris may present as dental pain. When this occurs, an improper diagn osis frequently leads to unnecessary dental treatment or, more significantl y, a delay of proper treatment. This delay may result in the patient experi encing an acute myocardial infarction. It is the dentist's responsibility t o establish a proper diagnosis so that the treatment will be directed towar d the source of pain and not to the site of pain. This article reviews the literature concerning referred pain of cardiac origin and presents a case r eport of toothache of cardiac origin.