Cardiac cephalgia: a diagnostic headache

Shankar, Abhinandan K; Allan, Caroline; Smyth, David; Jardine, David L.

doi:10.1111/imj.13217

Cited by 6 publications

(6 citation statements)

References 14 publications

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“… RCA 90% stenosis, LAD 75% stenosis, LCX 70% stenosis Huang, 2016 [ 52 ] F/70 Hypertension, Smoking None Evaluate ST elevation in V2-V6 NA Significant stenosis with intramural thrombus of LAD. Shankar, 2016 [ 53 ] M/73 Diabetes Chest pain NA Normal ST depression in inferior leads. Triple-vessel disease Current case M/40 Smoking Chest discomfort, palpitations Normal Inverted T wave Not performed Triple-vessel disease …”

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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“…However, detailed features of headache were not mentioned. Although there have been related reports in the past of moderate to severe headaches in variable locations, more than half of the patients do not have chest pain (4,10), and more detailed features, such as duration and accompanying symptoms, are incomplete. In addition, some scholars evaluated the diagnostic criteria, suggesting that the existing criteria do not have a good compliance rate (11), but better alternative criteria have not been proposed.…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of 30 cases of cardiac cephalalgia

Mao

Wang

et al. 2022

Cephalalgia

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Objective To investigate the clinical characteristics of cardiac cephalalgia and determine whether there is a more suitable alternative criterion. Method Patients with cardiac cephalalgia diagnosed and treated from May 2019 to April 2021 in the First Affiliated Hospital of Zhengzhou University (Zhengzhou, China) were prospectively and consecutively collected, their clinical manifestations were analyzed, and compared with the 2018 diagnostic criteria. Results A total of 30 patients were collected, including 16 males and 14 females. The onset age ranged from 31 to 84 years old, with a mean of 64.6 ± 11.9 years. Headache was more common in unilateral or bilateral frontotemporal, and the nature of pain includes pulsating, dull, stuffy pain, throbbing and so on. 80.0% were moderate to severe, 70% lasted less than half an hour, 76.6% had chest pain, 70% had chest tightness, 63.3% had sweating, and 36.6% had nausea. After treatment with drugs or coronary angiogenesis, except for one death, headache was fully or partially relieved in 29 patients. Conclusion Cardiac cephalalgia is generally located in frontotemporal region, of moderate or severe intensity, with a pulsating or throbbing sensation, abating within 30 minutes, and has a good prognosis. Accompanying chest pain, chest tightness, and sweating should be included in the diagnostic criteria.

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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%

“…In the cases where coronary angiography reveals occlusive disease, patients subsequently usually undergo coronary angioplasty, and their cardiac headaches resolve. 7,12,13 . However, our patient suffered from Prinzmetal angina with no indication for coronary angioplasty.…”

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%

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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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Cardiac cephalgia: a diagnostic headache

Cited by 6 publications

References 14 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

Clinical analysis of 30 cases of cardiac cephalalgia

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

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