Cargando…
When orofacial pain needs a heart repair
OBJECTIVES: The association of chronic orofacial pain (COFP) and congenital heart disease has never previously been reported. We report the first case of COFP secondary to a right‐to‐left shunt (RLS) due to asymptomatic patent foramen ovale (PFO) in a patient with prothrombotic states. MATERIALS AND...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019759/ https://www.ncbi.nlm.nih.gov/pubmed/33247554 http://dx.doi.org/10.1002/cre2.359 |
_version_ | 1783674439576059904 |
---|---|
author | Adamo, Daniela Calabria, Elena Coppola, Noemi Pecoraro, Giuseppe Buono, Giuseppe Mignogna, Michele Davide |
author_facet | Adamo, Daniela Calabria, Elena Coppola, Noemi Pecoraro, Giuseppe Buono, Giuseppe Mignogna, Michele Davide |
author_sort | Adamo, Daniela |
collection | PubMed |
description | OBJECTIVES: The association of chronic orofacial pain (COFP) and congenital heart disease has never previously been reported. We report the first case of COFP secondary to a right‐to‐left shunt (RLS) due to asymptomatic patent foramen ovale (PFO) in a patient with prothrombotic states. MATERIALS AND METHODS: A 48‐year‐old female patient presented with a 10‐month history of left‐sided facial pain who was initially diagnosed with persistent idiopathic facial pain (PIFP) on account of its similar characteristics. Magnetic resonance imaging (MRI) of the brain revealed gliosis and carotid siphon tortuosity; in addition, hyperhomocysteinaemia due to the homozygosis mutation for 5,10 MethyleneTetraHydroFolate Reductase was identified. Transcranial doppler ultrasonography was requested from a neurology consultant which revealed a high degree of RLS. Subsequently, a cardiological evaluation was performed; the specialist requested a transesophageal echocardiography that detected an interatrial septum aneurysm with PFO. RESULTS: Based on the analysis of the patient's high degree of RLS, prothrombotic state and gliosis in relation to age, the cardiological consultant chose to perform a percutaneous closure of the PFO to avoid the risk of a cryptogenic stroke. After PFO closure, a complete remission of the pain was obtained. CONCLUSIONS: The disappearance of the pain supports the possible association between RLS and COFP. PFO with RLS has been suggested as a risk factor for cryptogenic stroke, especially in association with other thromboembolic risk factors. Therefore, the early detection, in this case, could be considered a possible lifesaver. Communication between different care providers is essential when the patient presents symptoms of facial pain which are of an atypical nature. |
format | Online Article Text |
id | pubmed-8019759 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80197592021-04-08 When orofacial pain needs a heart repair Adamo, Daniela Calabria, Elena Coppola, Noemi Pecoraro, Giuseppe Buono, Giuseppe Mignogna, Michele Davide Clin Exp Dent Res Short Communication OBJECTIVES: The association of chronic orofacial pain (COFP) and congenital heart disease has never previously been reported. We report the first case of COFP secondary to a right‐to‐left shunt (RLS) due to asymptomatic patent foramen ovale (PFO) in a patient with prothrombotic states. MATERIALS AND METHODS: A 48‐year‐old female patient presented with a 10‐month history of left‐sided facial pain who was initially diagnosed with persistent idiopathic facial pain (PIFP) on account of its similar characteristics. Magnetic resonance imaging (MRI) of the brain revealed gliosis and carotid siphon tortuosity; in addition, hyperhomocysteinaemia due to the homozygosis mutation for 5,10 MethyleneTetraHydroFolate Reductase was identified. Transcranial doppler ultrasonography was requested from a neurology consultant which revealed a high degree of RLS. Subsequently, a cardiological evaluation was performed; the specialist requested a transesophageal echocardiography that detected an interatrial septum aneurysm with PFO. RESULTS: Based on the analysis of the patient's high degree of RLS, prothrombotic state and gliosis in relation to age, the cardiological consultant chose to perform a percutaneous closure of the PFO to avoid the risk of a cryptogenic stroke. After PFO closure, a complete remission of the pain was obtained. CONCLUSIONS: The disappearance of the pain supports the possible association between RLS and COFP. PFO with RLS has been suggested as a risk factor for cryptogenic stroke, especially in association with other thromboembolic risk factors. Therefore, the early detection, in this case, could be considered a possible lifesaver. Communication between different care providers is essential when the patient presents symptoms of facial pain which are of an atypical nature. John Wiley and Sons Inc. 2020-11-28 /pmc/articles/PMC8019759/ /pubmed/33247554 http://dx.doi.org/10.1002/cre2.359 Text en © 2020 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Short Communication Adamo, Daniela Calabria, Elena Coppola, Noemi Pecoraro, Giuseppe Buono, Giuseppe Mignogna, Michele Davide When orofacial pain needs a heart repair |
title | When orofacial pain needs a heart repair |
title_full | When orofacial pain needs a heart repair |
title_fullStr | When orofacial pain needs a heart repair |
title_full_unstemmed | When orofacial pain needs a heart repair |
title_short | When orofacial pain needs a heart repair |
title_sort | when orofacial pain needs a heart repair |
topic | Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019759/ https://www.ncbi.nlm.nih.gov/pubmed/33247554 http://dx.doi.org/10.1002/cre2.359 |
work_keys_str_mv | AT adamodaniela whenorofacialpainneedsaheartrepair AT calabriaelena whenorofacialpainneedsaheartrepair AT coppolanoemi whenorofacialpainneedsaheartrepair AT pecorarogiuseppe whenorofacialpainneedsaheartrepair AT buonogiuseppe whenorofacialpainneedsaheartrepair AT mignognamicheledavide whenorofacialpainneedsaheartrepair |