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Toothache, a signal for cardiac arrest

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Last Updated : 11 October 2013, 14:29 IST
Last Updated : 11 October 2013, 14:29 IST

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As bizarre as it might sound, a toothache symptom might be an indication of a cardiac arrest, enlightens Dr Amar Singhal

Have you ever experienced a toothache while doing something physically stressful and found immediate relief after taking some rest? Is your dentist unable to relieve you of your toothache even after your frequent visits?

It may sound scary but the above reasons may be the symptoms of Angina pectoris, or heart spasm, caused by inadequate supply of oxygenated blood to the heart muscle because of narrowing of the arteries to the heart.

It can ignite a radiating pain to the left side of the jaw. Patients with a history of heart disease should be cautious after a sudden toothache, especially if they are in good dental health, as it may be a signal of a heart attack.

48 year old corporate official Ashish Sahni is a diabetic and non hypertensive with a history of coronary artery disease (CAD) who also had to undergo angioplasty once. He recently arrived at our hospital with complaints of frequent pain in his lower jaw.

Though he had no complaints of chest pain, heaviness, discomfort or difficulty in breathing, we recommended doing his ECG because of his history of CAD. The reports showed ischemic changes in his heart. These changes were not a very good sign and signaled that the heart was not getting enough oxygen to its tissues and muscles.

Thus, he was advised coronary angiography but Ashish denied going through the procedure as he was unable to understand the relation of his pain with the heart. 

Like Ashish, there are many people suffering from similar toothache problems but are completely unaware of the fact that these may be associated with something as serious as a heart attack. They remain ignorant thinking of it as bizarre. Heart diseases and heart attacks do list tooth pain as a symptom.

The pain may feel like it’s radiating outward from the teeth or along the jaw, or can even feel like earache. Bacteria from the mouth (oral bacteria) if enters into the blood vessels will stick to the deposition of fat in the arteries of the heart and will lead to clots that cause coronary heart disease, inflammation of muscle and heart valves (endocarditis). All that obstruct the blood flow and distribution of food resources and oxygen to the heart, resulting to the heart’s inability to function properly.

Again, this does not mean that everyone who is experiencing a toothache runs the risk of having a heart attack; it is a blatant warning. But for people who have any kind of history of heart or coronary trouble, extra attention is required especially if the toothache is accompanied with light-headedness or sweating.

Till few years ago, health professionals were not aware that certain oral bacteria, if permitted entrance into the gingival blood vessels, could cause some strokes and heart attacks. Toothache remains one of the discreet symptoms but, researchers say that Craniofacial pain is the sole symptom of Cardia Ischemia (a condition of insufficient blood flow to the heart muscle) or Acute Myocardial Infarction and is almost 10 times more common in females than in males.

If the pain persists, then it may be acute myocardial infarction (AMI). Craniofacial pain symptoms mixed with the classic cardiac symptoms include pain felt at throat, left mandible (lower jawbone), right mandible, ears, jaw joints and teeth.

So ideally, every toothache will not result in heart attack but if it does, then it can even be life threatening. Dentists and physicians should play a significant role in charting out the fact that every unexplained orofacial and craniofacial pain should be an indication to rule out cardiac ischemia.

(The writer is a cardiologist)

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Published 11 October 2013, 14:29 IST

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