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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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Cardiac cephalalgia-headache as an atypical presentation of ST-segment elevation myocardial infarction: a case report

Udayanga Andadola1, Subhani Poornima2, Gamini Galappatthy2

  • 1Department of Primary Care and Family Medicine, Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Ratnapura, Sri Lanka. udayanga@med.sab.ac.lk.

BMC Cardiovascular Disorders
|June 7, 2025
PubMed

Insights

Cardiac cephalalgia, a rare migraine-like headache, can signal acute coronary syndrome. Prompt diagnosis and treatment of myocardial ischemia are crucial for symptom resolution, especially in patients with cardiovascular risk factors.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Ischaemic heart disease often presents with chest pain but can manifest atypically.
  • Cardiac cephalalgia is a rare condition where myocardial ischemia triggers a migraine-like headache.
  • A high index of suspicion is necessary for diagnosing cardiac cephalalgia.

Purpose of the Study:

  • To report a case of cardiac cephalalgia secondary to acute coronary syndrome.
  • To emphasize the importance of considering cardiac etiologies in patients with severe headaches and cardiovascular risk factors.

Main Methods:

  • Case report of a 47-year-old male with diabetes and smoking history presenting with severe headache.
  • Diagnostic workup included electrocardiography, coronary angiography, and serum troponin I measurement.
  • Treatment involved percutaneous coronary intervention (stenting) of affected coronary arteries.

Main Results:

  • The patient presented with acute, severe frontotemporal headache, nausea, and vomiting.
  • Electrocardiography showed ST-segment elevation, and coronary angiography revealed multivessel coronary artery disease.
  • Successful stenting of the coronary arteries led to symptom resolution and clinical improvement.

Conclusions:

  • This case underscores the critical need to consider cardiac causes, such as acute coronary syndrome, in patients presenting with severe headaches.
  • Identifying cardiac cephalalgia is vital, particularly in individuals with established cardiovascular risk factors.
  • Early recognition and management of myocardial ischemia can effectively resolve headache symptoms.
Abstract

Keywords:
Acute coronary syndromeCardiac cephalalgiaCase reportCoronary angiographyDiabetes mellitus

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