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Headache angina with fatal outcome.
K Takayanagi1, T Fujito, S Morooka
1Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Japanese Heart Journal
|July 1, 1990
Summary
Headache can be a primary symptom of angina pectoris, a serious heart condition. These cases highlight the importance of considering cardiac ischemia even when headache is the main complaint.
Area of Science:
- Cardiology
- Neurology
Background:
- Angina pectoris is typically associated with chest pain, but atypical presentations can occur.
- Understanding diverse ischemic attack symptoms is crucial for timely diagnosis and intervention.
Observation:
- Two patients presented with fatal angina pectoris, with headache as their predominant initial symptom.
- The first patient experienced ST-segment elevation and ventricular fibrillation during ambulatory electrocardiogram (ECG) monitoring.
- The second patient had post-infarction angina, preceded by headache and ST-segment elevation.
Findings:
- Both cases demonstrate a link between severe headache and acute myocardial ischemia.
- Electrocardiogram findings (ST-segment elevation) confirmed cardiac events in both patients.
- The underlying mechanism connecting headache and angina pectoris warrants further investigation.
Implications:
- Clinicians should consider cardiac ischemia in patients presenting with unexplained severe headaches, especially those with cardiac risk factors.
- Recognizing headache as a potential angina equivalent may improve early diagnosis and treatment of acute coronary syndromes.
- Further research is needed to elucidate the pathophysiology of headache during ischemic episodes.