A man in his 50s said, “I ride my bicycle to work every morning and every time I ride up the Qingliangmen Bridge my teeth hurt!” , which was finally checked for severe coronary stenosis. Dr. Liu Yanrong reminded everyone that toothache directly to the dentistry, heart problems are not properly paid attention to, it is likely to have an accident. The original article is as follows: The symptoms of typical angina pectoris are crushing pain in the lower and middle sternum, each attack lasts 3 to 5 minutes, once a few days or several times a day, radiating to the back and left upper extremity, mostly after exertion or emotional excitement, and disappear after rest or nitrate preparations. During the attack, there is ST-segment depression, transient ST-segment elevation and emerging T-wave inversion on the ECG, and the ECG returns to normal after the angina subsides. Angina pectoris is a clinical syndrome with episodes of chest pain or chest discomfort caused by acute temporary ischemia and hypoxia of the myocardium due to insufficient coronary artery blood supply. In fact, atypical angina is more common in clinical practice. Symptoms of atypical angina include epigastric pain, nausea and vomiting, dyspepsia, and even sharp or respiratory-related pleuritic pain, sudden dyspnea, etc. It can be said that all discomfort from the teeth to the belly button can be angina. Symptoms are mostly atypical in the elderly, women, diabetics, patients with renal insufficiency and dementia. I saw a male patient in his 50s who said, “I ride my bicycle to work every morning, and every time I ride up the Qingliangmen Bridge, my teeth hurt!” This statement aroused my high alert, and I immediately gave him an electrocardiogram, which indicated that the T waves in the anterior wall leads were obviously inverted, which was a “coronal T wave”, suggesting myocardial ischemia, and a coronary angiogram indicated severe coronary artery stenosis after hospitalization. It is a good thing that this patient was alert, if he had seen the stomatologist directly because of his toothache and did not pay proper attention to his heart problem, he might have had an accident. There are also patients who do not have obvious symptoms of cardiac discomfort and only present with severe shoulder and back pain. Last year there were two patients who had sudden syncope and cardiac arrest during acupuncture treatment for shoulder and back pain. One of them was only in his 40s and had no previous signs of heart disease, but fortunately was successfully resuscitated to save his life; the other was not so lucky, with an acute extensive anterior wall myocardial infarction and cardiogenic shock, which was not rescued. In atypical angina, severe ones can manifest as syncope. I was on emergency duty the other day when a 60-year-old woman, passing by the hospital entrance, had a sudden syncope and was brought to the emergency room. She felt that the problem was not serious and said that she had been seen in the cardiology and neurology clinics of a hospital before because of syncope, and all the tests had been done and no problem was found. In any case, patients with syncope should have an ECG as a rule. This patient’s ECG did not seem to be a big problem, but I found that the patient had an inverted T wave in the aVL lead. aVL lead T wave inversion usually indicates severe coronary artery left trunk lesion or severe triple branch lesion, and she was recommended to be hospitalized or kept under observation, but she did not agree. While she was being persuaded, the patient again syncope and immediately rechecked the ECG, which revealed ST-segment elevation in extensive leads and confirmed the diagnosis of coronary artery disease. Considering the severity of the patient’s symptoms and the low blood pressure during the attack, an emergency coronary angiogram was performed, which confirmed that the patient indeed had severe stenosis in multiple vessels, and the symptoms were relieved after stent implantation. When angina pectoris is suspected, it is very important to repeatedly recheck the ECG during the onset of angina pectoris or angina-like symptoms. Dynamic changes in the ECG are an important clue to the diagnosis of angina pectoris. Therefore, if you have hypertension, diabetes, hyperlipidemia, smoking, family history of coronary heart disease, are over 40 years old, and are given repeated ECGs because of heart discomfort or if a doctor suspects angina, please do not question that you are meeting a responsible doctor who is not trying to make more money, but is afraid of missing a diagnosis of life-threatening angina. If the symptoms of angina, which last significantly longer than before, or appear during light activity, or even at rest or during sleep, appear in combination with syncope, aura of syncope, severe dyspnea, accompanied by a large amount of cold sweat, this is a sign that the condition is very serious and it is best to rush to the hospital urgently. When you get to the hospital, if the doctor thinks that you need to do coronary angiography and implant a coronary stent urgently, you must also listen to the doctor. Open the coronary artery in order to save the dying heart muscle in time, time is heart muscle, time is life.