True Story: Toothache and the Heart Attack – ACLS

“It’s just a toothache and I really wish everyone would stop making it such a big deal!” spouted off the feisty 78 year old woman sitting in triage.  Her “toothache” began sometime during the night and she figured she’d see a dentist in the morning.  Fortunately her daughter followed her “gut instinct” that this was something more.  It was….she was having a heart attack.


Women are a little unique when it comes to recognizing the symptoms of a heart attack.  The hallmark symptoms of chest pressure, shortness of breath, arm pain, neck pain, nausea and/or dizziness may occur, which is the standard watch-list for suspicions of cardiac injury.  However, women generally experience other symptoms which may not be as easily recognized for being related to heart distress.


As in the case above where the elderly woman did not associate a “toothache” with her heart, frequently minor symptoms are mistaken for other problems when the cardiac event occurs.  Symptoms such as earlobe pain, shoulder pain, back pain, elbow or arm pain and stomach ache are also associated with cardiac injury for women.  Pair these with a history of diabetes, high cholesterol, obesity, smoking, menopause and a family history of cardiac illness and you have the perfect mix of “red flag” symptoms for cardiac injury, MI (myocardial infarction) or ischemia – aka: heart attack.


While calling 9-1-1 to activate first responder assistance isn’t always appropriate with usual every-day symptoms typical of baseline “aches and pains” or the “flu”, placing that 9-1-1 call is always appropriate when these symptoms are atypical or of sudden onset, generally unusual.  When in doubt, seek help.  The health care professionals will assess, triage and initiate appropriate action based on ACLS protocols and hospital protocols.   Paying attention to a symptom as a woman can save your heart injury and possibly save your life.


Perhaps the unusual “ache” is really your heart crying out for help – the help received from trained health care professionals.  Consider the combination of contributing factors (symptoms, medical and family history) the next time you feel a toothache.  You may just decide to visit the ER…and not your dentist.

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