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Cephalalgia-A "Tricky" Symptom for the Cardiologist: Acute Coronary Syndrome Presenting as Headache

Alexandros Vassiliades1, Varnavas Dimitriades1, Vasiliki Vanesa Stylianou1

  • 1Department of Cardiology Larnaca General Hospital, State Health Services Organization Larnaca Cyprus.

Clinical Case Reports
|February 26, 2026
PubMed

Insights

Headache can be a rare, primary symptom of acute myocardial ischemia. Prompt diagnosis using electrocardiograms and cardiac biomarkers is crucial for timely treatment.

Area of Science:

  • Cardiology
  • Neurology

Background:

  • Acute myocardial ischemia typically presents with chest pain.
  • Atypical presentations of myocardial ischemia are less common but clinically significant.

Purpose of the Study:

  • To highlight headache as a potential sole presenting symptom of acute myocardial ischemia.
  • To emphasize the importance of recognizing atypical myocardial ischemia presentations.

Main Methods:

  • Case review and literature synthesis on myocardial ischemia presentations.
  • Analysis of diagnostic criteria for acute myocardial ischemia.

Main Results:

  • Headache was identified as the primary or sole symptom in rare cases of acute myocardial ischemia.
  • Delayed diagnosis can occur when headache is the only presenting symptom.

Conclusions:

  • Clinicians must consider acute myocardial ischemia in patients presenting with unexplained headache.
  • Electrocardiograms and cardiac biomarkers are essential for diagnosing myocardial ischemia, even with atypical symptoms.

Keywords:
acute coronary syndromecephalalgiaheadachemyocardial ischemia

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