J Oral Facial Pain Headache. 2014 Fall;28(4):317-21. doi: 10.11607/ofph.1257.
To investigate possible associations between the presence of craniofacial pain of cardiac origin and the location of cardiac ischemia and conventional risk factors.
A total of 326 consecutive patients with confirmed myocardial ischemia (192 males, 134 females, mean age 64 years) were studied. Demographic details, health history, factors, prodromal symptoms, electrocardiogram (ECG) findings, and pain characteristics during the ischemic episode were assessed. The location of the ischemia according to the ECG findings was categorized as anterior, inferior, or lateral. Univariate chi-square analyses and a multivariate logistic regression model were used for data analysis. Two age subgroups (< 65 and > 65) were established when controlling for covariates.
Craniofacial pain of cardiac origin was significantly associated with an inferior localization of cardiac ischemia (P < .001) and was more frequently reported in diabetic patients (P = .014). Thirty-eight patients (12%) did not experience chest pain during the myocardial ischemia. Nine patients (3%) experienced a prodromal angina episode without chest pain.
The occurrence of craniofacial pain during myocardial ischemia, with or without an acute myocardial infarction, was associated with ischemia within the inferior wall. This result suggests the involvement of the vagal afferent system in the mechanisms of craniofacial pain of cardiac origin.
研究心源性颅面痛与心肌缺血部位和常规危险因素之间可能存在的关联。
共研究了 326 例确诊为心肌缺血的连续患者（男性 192 例，女性 134 例，平均年龄 64 岁）。评估了人口统计学细节、健康史、危险因素、前驱症状、心电图（ECG）发现以及缺血发作期间的疼痛特征。根据 ECG 发现将缺血部位分为前壁、下壁或侧壁。使用单变量卡方分析和多变量逻辑回归模型进行数据分析。控制协变量后，建立了两个年龄亚组（<65 岁和>65 岁）。
心源性颅面痛与心肌缺血的下壁定位显著相关（P<.001），并且在糖尿病患者中更为常见（P=.014）。38 名患者（12%）在心肌缺血期间没有经历胸痛。9 名患者（3%）在没有胸痛的情况下经历了前驱心绞痛发作。
心肌缺血期间发生的颅面痛，无论是否伴有急性心肌梗死，均与下壁缺血有关。这一结果表明，迷走传入系统可能参与了心源性颅面痛的发生机制。
