A case of cardiac cephalalgia showing reversible coronary vasospasm on coronary angiogram.
BACKGROUND
Under certain conditions, exertional headaches may reflect coronary ischemia.


METHODS
A 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection.


CONCLUSIONS
A coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test.
Yang
Youngsoon
Y
Department of Neurology, Hyoja Geriatric Hospital, Yongin, Korea.
Jeong
Dushin
D
Jin
Dong Gyu
DG
Jang
Il Mi
IM
Jang
Younghee
Y
Na
Hae Ri
HR
Kim
Sanyun
S