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La cefalgia cardíaca como una manifestación de eventos coronarios agudos: una revisión sistemática
Rosemary Siby1, Doju Cheriachan2, Sanjay Kumar3
1Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus
|August 22, 2025
Resumen
La cefalgia cardíaca (dolor de cabeza por isquemia cardíaca) es un síntoma raro y a menudo pasado por alto del ataque cardíaco. Los dolores de cabeza inexplicables en pacientes con riesgos cardíacos pueden indicar cefalgia cardíaca, lo que requiere una investigación cardíaca adicional.
Área de la Ciencia:
- Cardiología
- Neurología
- Diagnóstico médico
Sus antecedentes:
- Los síndromes coronarios agudos (SAC) pueden presentarse de manera atípica, especialmente en mujeres y ancianos, lo que plantea dificultades de diagnóstico.
- La cefalgia cardíaca (CC), un dolor de cabeza relacionado con la isquemia miocárdica, es una manifestación poco reconocida del SCA.
- Las directrices clínicas actuales rara vez abordan el CC, destacando una brecha en los protocolos de diagnóstico para los dolores de cabeza inexplicables.
Objetivo del estudio:
- Revisar y sintetizar sistemáticamente la literatura existente sobre la cefalgia cardíaca.
- Investigar los desafíos de diagnóstico y las características clínicas de la CC.
- Evaluar el papel potencial de la CC como síntoma aislado de la isquemia miocárdica.
Principales métodos:
- Se realizó una búsqueda sistemática de la literatura en seis bases de datos principales (PubMed, SCOPUS, Web of Science, ProQuest, Google Scholar, EBSCO) desde el año 2000 hasta el año 2023.
- Los estudios se seleccionaron en función de las directrices de PRISMA 2020, incluidos los ECA, los estudios de cohorte y los informes de casos.
- Diez estudios con un total de 80.202 participantes cumplieron con los criterios de inclusión.
Principales resultados:
- El CC puede ser el único síntoma de isquemia miocárdica.
- Los dolores de cabeza son frecuentemente diagnosticados erróneamente como trastornos de dolor de cabeza primario.
- Se observó una mejoría sintomática con el tratamiento con nitratos y intervenciones coronarias.
Conclusiones:
- Los médicos deben considerar el CC en pacientes con dolores de cabeza inexplicables y factores de riesgo cardiovascular.
- Es esencial realizar más investigaciones prospectivas para establecer los criterios de diagnóstico del CC.
- Se recomienda integrar las evaluaciones cardíacas en los protocolos de evaluación del dolor de cabeza para los pacientes en riesgo.
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