Jaw pain can be a sign of a heart attack, a fact often missed because people typically associate a cardiac event only with chest discomfort. This atypical presentation is a serious symptom of a myocardial infarction. Recognizing that pain can manifest far from the heart is a first step toward prompt action, as early treatment dramatically improves outcomes. This symptom is common in certain demographics, making awareness a matter of public health.
Referred Pain: The Connection Between the Heart and Jaw
The connection between a failing heart and pain in the jaw is explained by a neurological phenomenon known as referred pain. This occurs because the nerves that transmit pain signals from the heart share pathways with nerves that serve other parts of the body, including the face and jaw.
The sensory nerve fibers that carry information from the heart (visceral afferents) converge with somatic sensory nerves in the dorsal horn of the spinal cord. Specifically, these nerve signals from the heart enter the spinal cord at the thoracic segments T1 through T5. The brain misinterprets the origin of the signal because these converging nerves use the same relay stations. Since the brain is more accustomed to receiving signals from the somatic nerves—which govern the skin, muscles, and bones—it mistakenly projects the internal cardiac pain to the external body area served by those somatic nerves, such as the jaw, neck, or arm.
Another element is the vagus nerve, which is implicated in atypical cardiac pain. The vagus nerve’s sensory branches from the heart may relay pain information to brainstem nuclei, which also receive input from the trigeminal nerve that innervates the face and jaw. This neurological cross-talk tricks the central nervous system into perceiving the pain as originating in the jaw, even though the problem lies with the heart.
How to Distinguish Heart-Related Jaw Pain
Differentiating jaw pain caused by a heart attack from common causes like temporomandibular joint (TMJ) issues or dental problems requires attention to the pain’s nature and accompanying symptoms. Heart-related jaw pain is typically described as a pressure, aching, or tightness, rather than the sharp, localized pain of a toothache or the clicking discomfort of a joint disorder. This discomfort often feels like a squeezing or fullness that may last for several minutes or disappear and then return.
The pain frequently involves the lower jaw, radiating up to the ear, and may also spread to the neck, shoulder, or back. While it is often discussed in relation to the left side, cardiac jaw pain can occur on the right side or affect both sides of the jaw. A primary difference from other jaw pain causes is that cardiac pain often begins or worsens during physical exertion or emotional stress.
The presence of other symptoms indicates a cardiac origin. For women, jaw pain may be the primary or sole symptom of a heart attack, often without the traditional crushing chest pain. Recognizing this atypical presentation is important for women seeking medical attention.
Associated Symptoms
Associated symptoms often accompany cardiac jaw pain:
- Unexplained shortness of breath.
- Nausea or vomiting.
- Lightheadedness.
- Breaking out in a cold sweat.
Emergency Protocol and Associated Risk Factors
If jaw pain is sudden, severe, or accompanied by suspicious symptoms, call 911 or your local emergency number immediately. Do not attempt to drive yourself or the person experiencing symptoms to the hospital, as emergency medical services (EMS) personnel can begin life-saving treatment en route. While waiting for help, the person should stop all physical activity and sit or lie down comfortably.
If advised by a medical professional or dispatcher, and if there are no known allergies or contraindications, chewing a standard 162 to 325 mg dose of non-enteric coated aspirin is recommended. Aspirin helps thin the blood and can improve blood flow to the heart muscle, potentially limiting damage during the acute event. Chewing the tablet allows for faster absorption into the bloodstream than swallowing it whole.
Understanding personal risk factors is important for evaluating jaw pain. The probability that jaw pain is cardiac increases significantly for individuals with existing risk factors for coronary artery disease. These factors include advanced age, a family history of heart disease, high blood pressure, high cholesterol, smoking, and diabetes. For people with these predispositions, any new or unusual jaw discomfort warrants immediate medical attention.