Headache: An unusual presentation of acute myocardial infraction

Asvestas, Dimitrios

doi:10.4330/wjc.v6.i6.514

Cited by 10 publications

(5 citation statements)

References 11 publications

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“… NA ST evaluate in II, III, aVF NA RCX 99% stenosis Source Sex/Age Symptoms of Cardiac ischemia Cardiac Enzyme ECG Stress Test DSA Dalzell, 2009 [ 44 ] F/44 Smoking None NA ST evaluate in II, III, aVF NA RCA occlusion Sendovski, 2009 [ 45 ] F/65 Hyperlipidemia, Hypertension, None Evaluate ST depression at lateral wall and a mild ST elevation at precordial leads. NA LAD 70% stenosis, LCX 95% stenosis, RCA 80% stenosis, RPD 90% stenosis Chatzizisis, 2010 [ 46 ] M/42 Diabetes None Evaluate ST depression and invert T in V2-V5 NA LAD occlusion Yang, 2010 [ 4 ] F/44 None Chest discomfort, epigastric pain NA Normal ST depression Vasospasm of the right coronary artery in response to an intra-arterial injection of acetylcholine Costopoulos, 2011 [ 47 ] M/55 Hyperlipidemia, Hypertension, Smoking, Diabetes Breathlessness Evaluate Widespread ST segment depression NA Triple-vessel disease Elgharably, 2013 [ 48 ] M/55 Smoking None Evaluate Q wave in III, aVF NA Significant lesion with thrombus in LAD Asvestas, 2014 [ 49 ] M/86 Hypertension, Smoking None Evaluate ST depression in V1-V5, ST elevation in V7-V9 NA LCX occlusion, LAD and RCA severe stenosis Mathe...…”

Section: Resultsmentioning

confidence: 99%

Cardiac cephalalgia: one case with cortical hypoperfusion in headaches and literature review

Wang

Liu

et al. 2017

J Headache Pain

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BackgroundCardiac cephalalgia (CC) is a rare disease occurring during an episode of myocardial ischemia and relieved by nitroglycerine. Though more than 30 cases of CC have been reported since 1997, the mechanism is yet obscure. Herein, a case of CC is presented and discussed in relevance with previous literature to propose a novel hypothesis about the mechanism of CC.MethodA CC patient with cortical hypoperfusion during headache attacks was presented, which has never been reported. All published cases of CC via PubMed (http://www.ncbi.nlm.nih.gov/pubmed) in English literature, between 1997 and 2016, were reviewed.ResultsA patient suffering from CC presented a cerebral hypoperfusion during a headache attack. This phenomenon had not been observed since CC was introduced in 1997. The literature review summarized the clinical presentations, neuroimaging features, ECG, and coronary angiography features of 35 CC patients.ConclusionBased on the phenomenon of hypoperfusion in the event of a headache, the vessel constriction hypothesis was proposed including two potential physiological mechanisms underlying the pathophysiology of CC.

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Section: Resultsmentioning

confidence: 99%

Cardiac cephalalgia: one case with cortical hypoperfusion in headaches and literature review

Wang

Liu

et al. 2017

J Headache Pain

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“…In several published cases, headache (extertional) could be the only manifestation of a myocardial infarction or angina pectoris, although this occurs very rarely. 7,8 Cardiac cephalgia manifests without a specific pattern of clinical features, it can present in a form of migraine, sometimes even accompanied by autonomic symptoms, or in a form of tension-type headache. 10 Pain location and accompanying symptoms are highly variable; however, the most consistent feature is severe headache intensity.…”

Section: Discussionmentioning

confidence: 99%

“…The headache usually presents along with typical symptoms of angina pectoris; it may occasionally present as exertional headache without chest symptoms. 7,8 Within this headache subtype there is a high variability of clinical manifestations, so CC is probably not recognized in a number of cases and thus underdiagnosed. 6,9 Differential diagnosis with migraine is crucial to avoid the administration of vasoconstrictors.…”

Section: Introductionmentioning

confidence: 99%

a Cardiac cephalalgia attacks provoked by Prinzmetal angina - a case report

Cvetković

Jensen

2021

MRAJ

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A 51-year-old man with no past medical history of headache or risk factors for vascular diseases was diagnosed with supraventricular tachycardia (SVT) in 2005. In 2014 SVT attacks were longer and always followed by severe headache attacks. Accompanying symptoms were dizziness, non-rotational vertigo, confusion, episodes of double vision and tinnitus; these symptoms would last one day, followed by severe tiredness for 2 days. Neurologic and cardiologic evaluation as well as extensive diagnostic test between the attacks was normal. Catheter coronarography showed no stenoses but did show spasms in distal left anterior descending artery. A remarkable effect on SVT and headaches was shown after the introducement of diltiazem. The diagnosis cardiac cephalalgia (CC) was established. As our case report is unique, we hope that our observations will help cardiologists and neurologists to better understand and treat patients with CC. CC should be distinguished from migraine, to avoid prescribing triptans and vasoconstrictors.

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“…With myocardial ischemia, a headache may or may not be accompanied by chest pain. In most cases, patients also had chest pain (17)(18), but cases of patients whose headache was the only symptom of angina pectoris or a coronary event have also been described (19)(20)(21).…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Very often, this form of headache is misdiagnosed as a migraine. According to data from literature, these patients can have undiagnosed cardiac cephalalgia for years before acute myocardial infarction occurs (19). Triptans should be avoided in patients with myocardial infarction, cerebrovascular insult, uncontrolled hypertension, or diabetes.…”

Section: Management Of Patients With Cardiac Cephalalgiamentioning

confidence: 99%

Cardiac cephalalgia

Cvetković,

Mijajlović,

Jokić

2023

Medicinska istraživanja

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Cardiac cephalalgia has a small incidence, but unrecognized it can prolong the time to diagnose a life-threatening condition such as acute coronary event. According to its clinical presentation, it can refer to a migraine. Even in the absence of clinically and laboratory evident signs, the diagnosis of cardiac migraine should be kept in mind because sometimes it is the only symptom of a threatening coronary event. The choice of treatment depends on a correctly established diagnosis. A reckless inclusion of vasoconstrictors as a standard therapeutic modality of migraine in a patient with a cardiac cephalalgia could worsen ischemia and endanger the patient's life. By solving an acute coronary event conservatively, with percutaneous coronary interventions or coronary "bypass," cardiac cephalalgia is eliminated as well.

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Headache: An unusual presentation of acute myocardial infraction

Cited by 10 publications

References 11 publications

Cardiac cephalalgia: one case with cortical hypoperfusion in headaches and literature review

Cardiac cephalalgia: one case with cortical hypoperfusion in headaches and literature review

a Cardiac cephalalgia attacks provoked by Prinzmetal angina - a case report

Cardiac cephalalgia

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