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Cardiac cephalalgia: severe, non-exertional headache presenting as unstable angina

Jonathan Lazari1, Andrew Money-Kyrle2, Benjamin R Wakerley3,4

  • 1Department of Cardiology, Buckinghamshire Healthcare NHS Trust, Amersham, UK j.lazari@doctors.org.uk.

Practical Neurology
|October 20, 2018
PubMed

Insights

Cardiac cephalalgia, a type of headache linked to myocardial ischemia, can be severe and linked to heart conditions. Successful stenting of a blocked coronary artery resolved the patient's severe headaches.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Cardiac cephalalgia is a rare headache syndrome associated with myocardial ischemia.
  • Headache characteristics vary, often severe, worsening with reduced heart blood flow and resolving with improved flow.

Observation:

  • A 64-year-old man presented with severe, frequent, non-exertional headaches over 6 months.
  • Electrocardiogram revealed ST elevation; troponin levels were normal.
  • Coronary angiography identified severe stenosis in the right coronary artery.

Findings:

  • Percutaneous coronary intervention successfully stented the stenosed right coronary artery.
  • The patient experienced complete resolution of headaches post-procedure.

Implications:

  • This case highlights the importance of considering cardiac cephalalgia in patients with unexplained headaches.
  • Coronary artery intervention can effectively treat headaches caused by myocardial ischemia.
  • Early diagnosis and treatment can significantly improve quality of life.

Keywords:
acute coronary syndromecardiac cephalalgiaunstable angina

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