Angina Cranialis: An Unusual Presentation of Referred Ischemic Myocardial Pain

Abstract

Headache was a very unusual presentation of acute myocardial ischemia. A case of acute myocardial infarction presented initially with only excruciating headache was reported. The abnormal electrocardiography and high level of serum creatine kinase-cardiac type (CK-MB) and cardiac troponin T confirmed the diagnosis. The headache totally disappeared after the intensive medical treatment of ischemic heart disease. This rare presentation of acute myocardial infarction should be considered in acutely severe headache cases after the intracranial causes of headache have been completely excluded.

A fatal headache with normal brain imaging

“…Cardiac cephalalgia presenting with headache not related to exertion has been reported. 6 Most of the patients reported in literature are elderly and has been diagnosed and treated. [6][7][8] Although cardiac cephalalgia is still considered a hypothetical condition, this fatal case illustrates the need to consider cardiac cephalalgia in any unexplained headache not responding to headache-specific treatment, even in the absence of red flag signs.…”