Facial pain of cardiac origin: a case report.

CONTEXT: Cardiac pain may radiate to the face and lead patients to seek dental care. Dentists may contribute towards the diagnosing of ischemic heart disease and thus refer patients for cardiological evaluation. CASE REPORT: A 50-year-old female patient was referred to a dentist for evaluation of a suspected temporomandibular disorder after repeated visits to medical emergency departments due to excruciating facial and left temporal pain associated with exertion. The pain would start in the chest and radiate to the neck, face and left temporal region. The patient's chief complaint was the facial pain; hence, she sought dental care. The dental examination revealed an edentulous upper jaw and partially edentulous lower jaw with full upper prosthetic set of teeth and decreased vertical dimension. X-ray of facial bones did not reveal any bone abnormalities. A diagnosis of temporomandibular disorder was made. However, she was referred for cardiological evaluation, since her pain was starting in the chest and because she had a past medical history of surgical treatment for coronary artery disease. A diagnosis of angina pectoris was made, the therapeutic regimen was optimized and her angina was brought under control.

Facial pain of cardiac origin: a case report / Dor facial de origem cardíaca: um relato de caso

CONTEXT: Cardiac pain may radiate to the face and lead patients to seek dental care. Dentists may contribute towards the diagnosing of ischemic heart disease and thus refer patients for cardiological evaluation. CASE REPORT: A 50-year-old female patient was referred to a dentist for evaluation of a suspected temporomandibular disorder after repeated visits to medical emergency departments due to excruciating facial and left temporal pain associated with exertion. The pain would start in the chest and radiate to the neck, face and left temporal region. The patientÆs chief complaint was the facial pain; hence, she sought dental care. The dental examination revealed an edentulous upper jaw and partially edentulous lower jaw with full upper prosthetic set of teeth and decreased vertical dimension. X-ray of facial bones did not reveal any bone abnormalities. A diagnosis of temporomandibular disorder was made. However, she was referred for cardiological evaluation, since her pain was starting in the chest and because she had a past medical history of surgical treatment for coronary artery disease. A diagnosis of angina pectoris was made, the therapeutic regimen was optimized and her angina was brought under control.

CONTEXTO: A dor de origem cardíaca pode apresentar irradiação para a face e motivar pacientes a procurarem atendimento odontológico. Nestas situações, cirurgiões-dentistas podem contribuir para o diagnóstico da cardiopatia isquêmica e serem encaminhadores de pacientes para avaliação cardiológica. RELATO DE CASO: Mulher de 50 anos de idade, portadora de diabetes melito, foi encaminhada para avaliação odontológica de disfunção temporomandibular, depois de repetidas consultas em serviço de emergência em razão da dor facial e bitemporal associada ao esforço físico. A dor iniciava-se no tórax, irradiava para a região cervical, face e região temporal à esquerda há seis meses. Embora houvesse dor torácica, a queixa principal da paciente era de dor facial, o que a motivou à procura de atendimento odontológico. O exame odontológico revelou paciente edêntula na parte superior e desdentada parcial na inferior da boca, em uso de prótese total superior com perda da dimensão vertical. O exame radiográfico da face não mostrou anormalidades ósseas. Foi feito diagnóstico de disfunção temporomandibular, mas, tendo em vista a dor torácica e o antecedente de cardiopatia isquêmica operada, a paciente foi encami-nhada para avaliação cardiológica. Foi feito o diagnóstico de angina do peito e o quadro foi controlado com o ajuste do tratamento medicamentoso.

Dor cardiaca referida exclusivamente à face: revisão e relato de caso / Cardiac pain referred to the face: review and case report

Dor referida às estruturas orofaciais pode representar o início e o principal sintoma de insuficiência coronariana. Nestes casos, a história completa do paciente e seu exame físico constituem fatores essenciais para o correto diagnóstico. Porém, a dor referida na face, de origem cardíaca, pode representar um desafio para o clínico, por ser incomum, o que propicia prodecimentos odontológicos desnecessários e retardo no correto tratamento. O presente relato tem por objetivo apresentar um caso clínico incomum de dor cardíaca referida à face (angina pectoris), com queixa exclusiva de dor localizada neste último segmento corpóreo