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La cefalgia cardíaca como una manifestación de eventos coronarios agudos: una revisión sistemática

Rosemary Siby1, Doju Cheriachan2, Sanjay Kumar3

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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.

Palabras clave:
cefalgia cardíacaEnfermedades coronariasacontecimientos coronariosdolor de cabezaEnfermedad cardíacainsuficiencia cardíacaInfarto isquémicodolor de cabeza

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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.