Is Jaw Pain a Common Symptom of Heart Attack?
Yes, jaw pain is a recognized and relatively common symptom of myocardial infarction, occurring in approximately 6-32% of patients, with significantly higher rates in women compared to men. 1
Frequency and Demographics
Jaw pain occurs as part of the symptom complex in approximately one-third of heart attack patients, though it appears as the sole presenting symptom in only about 6% of cases. 2 The distribution varies significantly by sex and age:
Women experience jaw pain substantially more often than men: In the Global Registry of Acute Coronary Events study, 10% of women versus only 4% of men with acute coronary syndrome presented with jaw pain. 3
Younger women (≤55 years) report jaw/neck pain in 61.9% of cases compared to 54.8% of men in the same age group. 3, 4
Older adults (>75 years) frequently present with isolated jaw pain without any chest discomfort, making recognition particularly challenging. 3
Patients with diabetes are at higher risk for atypical presentations including jaw pain due to autonomic dysfunction. 1, 4
Clinical Characteristics of Cardiac Jaw Pain
The jaw pain from myocardial ischemia has specific features that distinguish it from dental or musculoskeletal causes:
Location: Typically involves the mandibular region bilaterally, though it may affect the left mandible, right mandible, or temporomandibular joint/ear region. 1, 2
Radiation pattern: The pain may radiate from the neck downward or occur in isolation without chest symptoms. 1, 3
Temporal relationship: When jaw pain has a clear relationship to physical exertion or emotional stress, or is relieved promptly with nitroglycerin, it should be considered equivalent to angina. 3
Associated symptoms: Jaw pain accompanied by dyspnea, diaphoresis, nausea, vomiting, or fatigue significantly increases the likelihood of cardiac origin. 1
Why Women Experience More Jaw Pain
Women have distinct pathophysiologic mechanisms underlying their heart attacks that explain different symptom patterns:
Women have a higher proportion of MI caused by non-classical mechanisms including plaque erosion, coronary microvascular dysfunction, coronary vasospasm, and spontaneous coronary artery dissection rather than typical plaque rupture. 3, 4
Women describe their chest pain differently than men—often as pressure, tightness, heaviness, or burning rather than crushing pain—and more frequently use words like "tearing" and "terrifying." 1, 4
Critical Clinical Pitfalls to Avoid
Never dismiss jaw pain as dental or musculoskeletal without excluding cardiac causes first, especially in women over 50, diabetics, and elderly patients. 3
Traditional risk assessment tools consistently underestimate cardiac risk in women and misclassify their symptoms as nonischemic pain. 1, 3, 4
Failing to obtain an ECG in patients with jaw pain who have cardiac risk factors (especially elderly, diabetics, women) is a critical error that delays life-saving treatment. 5
Assuming jaw pain requires typical exertional patterns is dangerous: Jaw pain occurring at rest can represent unstable angina or acute MI. 3, 6
Dental examination revealing no abnormalities does not exclude cardiac origin: Multiple case reports document patients treated for presumed dental disease who later suffered cardiac arrest. 7, 6
Immediate Action Required
When jaw pain is potentially cardiac in origin, immediate steps include:
Activate emergency medical services immediately for transport to the closest emergency department. 1
Obtain 12-lead ECG within 10 minutes of presentation. 4
Place patient in environment with continuous ECG monitoring and defibrillation capability. 3, 4
Assess cardiac biomarkers (troponin) in all patients with concerning symptoms or risk factors. 3
While awaiting EMS, encourage alert adults to chew and swallow aspirin 162-325 mg unless contraindicated by allergy or bleeding risk. 1
Risk Factor Assessment
Evaluate these specific factors that increase likelihood of cardiac jaw pain: