[Cardiac cephalgia: an underdiagnosed condition? ].
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.
Gutiérrez Morlote
Jesús
J
Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
Fernández García
José M
JM
Timiraos Fernández
Juan J
JJ
Llano Cardenal
Miguel
M
Llano Catedral
Miguel
M
Rodríguez Rodríguez
Eloy
E
Pascual Gómez
Julio
J
D000368:Aged; D004562:Electrocardiography; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000627:therapeutic use; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate