An obese patient describes pain at the left angle of the mandible that also radiates into the left arm. This pain is BEST characterized as:

Correct answer: B. Referred pain

• A. Labelling this psychosomatic would be a catastrophic error. The pattern demands cardiac workup, not reassurance.
• B. CORRECT. This is REFERRED pain, and the specific pattern is a medical emergency: left-sided jaw and arm pain in a patient with cardiovascular risk factors is CARDIAC pain from myocardial ischemia. Visceral afferents from the heart converge with somatic afferents in the upper thoracic and cervical cord segments, and the brain misattributes the source. Women, diabetics and older adults are especially likely to present with jaw pain rather than classic chest pain.
• C. Odontogenic pain would be reproducible on percussion or thermal testing and would not radiate into the arm.
• D. Neuropathic pain arises from nerve injury or dysfunction and is described as burning, electric or lancinating, following a nerve distribution — not a jaw-plus-arm pattern.

Note: ⚠️ Do not treat. Jaw pain radiating to the left arm in an at-risk patient = suspect acute coronary syndrome. Stop the appointment, place the patient in a comfortable position, give oxygen, activate EMS, and consider aspirin if not contraindicated.