Craniofacial pain can be the sole symptom of a heart attack or an acute cardiac ischemic episode and can also be the only prodromal symptom of an acute myocardial infarction. Failure to recognize its cardiac source can put the patient’s life at risk. The
most common craniofacial pain locations are the throat, mandible, temporomandibular joint/ear region and teeth. In the absence of chest pain, caniofacial pain was recently found to be the dominating symptom. The pain descriptors “pressure” and “burning” can now be added to those craniofacial pain characteristics already known to point to acute cardiac disease rather than dental pathology, i.e. pain provocation/aggravation by physical activity, pain relief at rest, and bilateralism. Because patients who have acute myocardial infarction without chest pain run a higher risk of experiencing a missed diagnosis and death, the dentist’s awareness of this symptomatology can be
crucial for early diagnosis and timely treatment.