Cardiac Ischemia
Cardiac Cephalgia
a rare symptom of ischemic heart disease at the time of the MI or angina episode, 6% of people will report a headache with the onset of heart problems along with the dominant sign of chest or arm pain.
Headache as the only symptom is very infrequent and is generally associate with other typically symptoms of heart attack
Headache as the only symptom is very infrequent and is generally associate with other typically symptoms of heart attack
Criteria for Diagnosis
- Headache, which may severe, aggravated by exertion and and accompanied by nausea
- Acute MI has occurred (based on the presence of ST- segment elevations or depression and presence of T-wave inversions on exercise ECG)
- headache develops concomitantly with acute myocardial ischemia
- headache resolves and does not recur after effective medical therapy for myocardial ischemia or coronary revascularization.
Signs and Symptoms
- Pain is not localized in a specific area but may involve the frontal, temporal, parietal, and occipital regions.
- headache can be unilateral or bilateral
- pain is always severe or excruciating, constrictive and oppressive
- in some cases symptoms accompanied by photophobia, osmophobia, and nausea.
- headache associated with chest constriction, pain in left arm radiating up to the mandible or epigastric pain.
- headache starts after physical exertion
- headache does not respond to NSAIDs
Differential Diagnosis
- Migraine
- Primary and secondary form of exertional heachaches
- Thunderclap headache
- Cough headache
Referral
if you suspect myocardial infarction based on patient’s presentation, call 911 immediately