Cardiac cephalalgia: First case from India.
A 67-year-old male smoker had exertional headaches for 2 years. The headaches were holocephalic, very severe, excruciating, and occasionally accompanied by nausea. Physical examinations and neuroimaging were normal. Electrocardiogram (ECG) showed old infarct in inferior leads. Sublingual nitrate provided relief in headaches. Stress test was positive with recurrence of similar headaches with ECG changes suggestive of myocardial ischemia. Coronary angiogram revealed three-vessel disease. Coronary artery bypass surgery provided complete resolution of headaches.
Department of Neurology, Smt Bhikhiben Kantilal Shah Medical Institute and Research Centre Medical College, Waghodia, Vadodara, Gujarat, India.
Sanjay
S
Prakash
Department of Cardiology, Smt Bhikhiben Kantilal Shah Medical Institute and Research Centre Medical College, Waghodia, Vadodara, Gujarat, India.
Nirav
N
Panchani
Department of Neurology, Smt Bhikhiben Kantilal Shah Medical Institute and Research Centre Medical College, Waghodia, Vadodara, Gujarat, India.
Chaturbhuj
C
Rathore
Department of Neurology, Smt Bhikhiben Kantilal Shah Medical Institute and Research Centre Medical College, Waghodia, Vadodara, Gujarat, India.
Prayag
P
Makwana
Department of Medicine, Smt Bhikhiben Kantilal Shah Medical Institute and Research Centre Medical College, Waghodia, Vadodara, Gujarat, India.
Mitali
M
Rathod
Angina; cardiac cephalalgia; coronary artery disease; exertional headache