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July 27, 2014: Cardiac cephalgia

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July 27, 2014

Cardiac cephalgia is a rare type of headache caused by acute myocardial ischemia with or without cardiac symptoms. It usually occurs after 50 years of age, in patients with cardiovascular risk factors, during or after exertion. Without a specific pattern of clinical features, it may mimic primary headaches such as migraine, tension-type headache and thunderclap headache. Distinguishing this type of headache from migraine is especially important as the use of vasoconstrictor agents - such as triptans - is contraindicated. The improvement with nitrates corroborates the diagnosis.

  1. Bini A, Evangelista A, Castellini P, et al. Cardiac cephalgia. J Headache Pain 2009;10:3–9

Submitted by: Inês Menezes Cordeiro, MD, Resident Physician, Department of Neurology, Centro Hospitalar do Algarve, Hospital de Faro, Portugal 

Dr. Cordeiro reports no disclosures.

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