Cardiac Cephalalgia

Chen, Shih‐Pin; Fuh, Jong Ling; Yu, Wen Chung; Wang, Shuu Jiun

doi:10.1159/000078489

Cited by 21 publications

(7 citation statements)

References 15 publications

(49 reference statements)

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“…III, aVF NA Not performed Morlote, 2002 [ 37 ] M/59 Hyperlipidemia, Hypertension Chest discomfort, diaphoresis. NA ST depression NA NA Source Sex/Age Risk Factors Symptoms of Cardiac ischemia Cardiac Enzyme ECG Stress Test DSA Sathirapanya, 2004 [ 38 ] M/58 Smoking Chest tightness NA ST elevation in V1-3 NA LM 50% stenosis, LAD occlusion, 1st OM 70% stenosis, RCX occlusion Chen, 2004 [ 39 ] M/76 Hypertension Chest pain NA T inversion in I, aVL ST depression in II, III, aVF LAD 90% stenosis, RCA 50% stenosis Korantzopoulos, 2005 [ 40 ] F/73 Hyperlipidemia, Hypertension, Obesity None Elevate ST depression in V2-V5 NA LAD 70% stenosis Cutrer, 2006 [ 5 ] M/53 Hyperlipidemia, Hypertension, Smoking, Obesity None NA NA Negative RCA occlusion, LAD 60% stenosis Morlote, 2006 [ 41 ] F/74 Diabetes, Obesity Chest tightness Evaluate ST depression in V1-V4 NA Not performed F/64 Hyperlipidemia, Hypertension, Diabetes None Not performed Not performed Not performed Not performed Seow, 2007 [ 42 ] M/35 Smoking None Evaluate ST evaluate in V2 to V4 ...…”

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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“…The frequency of this headache is highly variable; it may appear only in concomitance with the acute cardiovascular event [10, 11, 15–20] or may be more frequent and even occur daily [4, 5, 9, 21] for periods lasting from a few weeks [5, 9, 12, 13, 22–25] to several years [6, 8, 14, 21, 26, 27]. …”

Section: Clinical Featuresmentioning

confidence: 99%

“…Fifty-seven per cent of patients shows pathological alterations of the baseline ECG trace, such as ST-segment elevations or depressions and T-wave inversions [5, 8–11, 13, 15–20, 25, 27–29], as well as elevated cardiac enzymes [5, 7, 10, 11, 16–20, 26, 27]. …”

Section: Clinical Featuresmentioning

confidence: 99%

Cardiac cephalgia

et al. 2009

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The purpose of this review was to provide a critical evaluation of medical literature on so-called “cardiac cephalgia” or “cardiac cephalalgia”. The 2004 International Classification of Headache Disorders codes cardiac cephalgia to 10.6 in the group of secondary headaches attributed to disorder of homoeostasis. This headache is hardly recognizable and is associated to an ischaemic cardiovascular event, of which it may be the only manifestation in 27% of cases. It usually occurs after exertion. Sometimes routine examinations, cardiac enzymes, ECG and even exercise stress test prove negative. In such cases, only a coronary angiogram can provide sufficient evidence for diagnosis. Cardiac cephalgia manifests itself without a specific pattern of clinical features: indeed, in this headache subtype there is a high variability of clinical manifestations between different patients and also within the same patient. It “mimics” sometimes a form of migraine either accompanied or not by autonomic symptoms, sometimes a form of tension-type headache; on other occasions, it exhibits characteristics that can hardly be interpreted as typical of primary headache. Pain location is highly variable. When the headache occurs as the only manifestation of an acute coronary event, the clues for suspicion are a) older age at onset, b) no past medical history of headache, c) presence of risk factors for vascular disorders and d) onset of headache under stress. Knowledge of cardiac cephalgia is scarce, due to its rare clinical occurrence and to the scant importance given to headache as a symptom concomitantly with an ischaemic cardiac event.

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“…The concomitant occurrence of headache and myocardial ischemia is the key criterion (criterion C) for diagnosis. The proposed headache features (criterion A) are not generally satisfactory; in particular, nausea was the least commonly fulfilled criterion in the review study of the literature with the new ICHD-II criteria revisited,10 in which the proposed mechanisms of cardiac cephalalgia are described. One possible explanation is an anatomical connection.…”

Section: Discussionmentioning

confidence: 99%

A Case of Cardiac Cephalalgia Showing Reversible Coronary Vasospasm on Coronary Angiogram

et al. 2010

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BackgroundUnder certain conditions, exertional headaches may reflect coronary ischemia.Case ReportA 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection.ConclusionsA coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test.

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Cardiac Cephalalgia

Cited by 21 publications

References 15 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

Cardiac cephalgia

A Case of Cardiac Cephalalgia Showing Reversible Coronary Vasospasm on Coronary Angiogram

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