Headache as the sole clinical manifestation of acute myocardial infarction: one case with cardiac cephalalgia and literature review.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2024-11-01 Epub Date: 2024-06-14 DOI:10.1097/MCA.0000000000001394

Huili Cui, Lifeng Zhang, Taiqing Zhu, Rui Liu, Xueqian Yuan

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引用次数: 0

Abstract

Objective: Cardiac cephalalgia, once seen as a rare symptom of coronary artery disease, is now more recognized. It often comes with chest discomfort and autonomic dysfunction, worsened by physical activity. However, not all cases have chest symptoms or are activity induced. This report presents a case of cardiac cephalalgia and reviews 46 previous cases.

Method: We discuss a unique case where a patient had headache attacks without chest symptoms, autonomic dysfunction, or triggers. We reviewed English case reports of cardiac cephalalgia from 1982 to 2022 using PubMed ( http://www.ncbi.nlm.nih.gov/pubmed ).

Results: A 69-year-old man presented with a sudden headache without triggers or typical symptoms. Coronary computed tomography angiography (CTA) showed diffuse stenosis in the left anterior descending and the first diagonal branch arteries. His headache improved after percutaneous coronary intervention. Cardiac cephalalgia is usually marked by severe headaches, autonomic signs, and often affects the occipital region. Electrocardiogram (ECG) might not always show abnormalities, and chest pain is not always present. In such cases, elevated cardiac enzymes can be crucial for diagnosis.

Conclusion: When a headache is the sole symptom of an acute coronary event, consider moderate to severe intensity, older age at onset, occipital localization, and autonomic signs. ECG, cardiac enzymes, and coronary CTA are valuable for accurate diagnosis and treatment.

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头痛是急性心肌梗死的唯一临床表现：一例心源性头痛病例及文献综述。

目的：心源性头痛曾被视为冠状动脉疾病的一种罕见症状，现在已被越来越多的人所认识。它通常伴有胸部不适和自主神经功能障碍，体力活动时症状会加重。然而，并非所有病例都有胸部症状或由活动诱发。本报告介绍了一例心源性头痛病例，并回顾了 46 例既往病例：我们讨论了一个独特的病例，患者头痛发作时没有胸部症状、自主神经功能障碍或诱因。我们使用 PubMed (http://www.ncbi.nlm.nih.gov/pubmed)回顾了 1982 年至 2022 年期间有关心脏性头痛的英文病例报告。结果：一名 69 岁的男性突发头痛：一名 69 岁的男性突发头痛，无诱因或典型症状。冠状动脉计算机断层扫描（CTA）显示左前降支动脉和第一对角支动脉弥漫性狭窄。经皮冠状动脉介入治疗后，他的头痛有所好转。心源性头痛通常以剧烈头痛和自主神经体征为特征，并经常影响枕部。心电图（ECG）不一定总是显示异常，胸痛也不一定总是出现。在这种情况下，心肌酶升高可能是诊断的关键：结论：当头痛是急性冠状动脉事件的唯一症状时，应考虑中度至重度头痛、发病年龄较大、枕部定位和自主神经体征。心电图、心肌酶和冠状动脉 CTA 对准确诊断和治疗很有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.