Brief Reports
Cardiac Cephalgia: an Underdiagnosed Condition?

https://doi.org/10.1016/S1885-5857(06)60757-3Get rights and content

Cardiac cephalgia, or headache occurring as manifestation of myocardial ischemia, has only recently been recognized as a distinct entity. In patients with known ischemic cardiopathy, its diagnosis depends on the presence of severe headache that is accompanied by nausea, worsened by physical exercise, and only ceases with nitrate administration. We report on two patients who met diagnostic criteria for this entity. In both, headache was the only symptom of coronary ischemia, and delayed its diagnosis. Headache occurred both at rest and during exertion, and resolved only after the administration of nitrates. Cardiac cephalgia should be suspected in patients with a history of ischemic cardiopathy who present with de novo headache, even when thoracic pain is absent, especially if the headache improves with nitrates. Differential diagnosis with migraine is crucial to avoid the administration of vasoconstrictors.

La cefalea cardíaca, o cefalea como manifestación de isquemia miocárdica, es una entidad individualizada recientemente. Su diagnóstico en un paciente con cardiopatía isquémica requiere una cefalea intensa, acompañada de náuseas y empeorada por el ejercicio, que cede tras la administración de nitratos. Presentamos los casos de 2 pacientes que cumplían estos criterios diagnósticos. En ambos, esta cefalea fue el único síntoma de isquemia coronaria, lo que retrasó el diagnóstico, aconteció con esfuerzos y en reposo, y sólo cedió tras la administración de nitratos. La cefalea cardíaca ha de sospecharse en pacientes con cardiopatía isquémica que consultan por cefalea de reciente comienzo, aunque no presenten dolor torácico, sobre todo si mejoran con nitratos. El diagnóstico diferencial con la migraña es crucial de cara a evitar medicaciones vasoconstrictoras.

REFERENCES (9)

  • RB Lipton et al.

    Cardiac cephalgia: a treatable form of exertional headache

    Neurology.

    (1997)
  • The International Classification of Headache Disorders. 2nd ed

    Cephalalgia.

    (2004)
  • J Gutiérrez-Morlote et al.

    Cardiac cephalgia is not necessarily an exertional headache

    Cephalalgia.

    (2002)
  • SP Chen et al.

    Cardiac cephalgia. Case report and review of the literature with new ICHD-II criteria revisited

    Eur Neurol.

    (2004)
There are more references available in the full text version of this article.

Cited by (0)

View full text