Variant form of angina pectoris diagnosed by the reffered pain lower jaw

A 76-year-old male, patient with lower jaw pain was studied.Though the patient had no history of angina pectoris and no chest pain, ambulatory electrocardiography showed the elevation of ST segments in early morning, which followed lower jaw pain. This transient elevation of ST segments was reduced by coronary vasodilator and at that time, the lower jaw pain was completely relieved.In this way, a careful history and long-recording electrocardiography established a diagnosis of the variant form of angina pectoris and it reffered pain in the lower jaw.