Headache as a manifestation of fatal myocardial infarction

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
J AuerB Eber

Abstract

Cardiac ischemia typically causes chest pain, variously radiating elsewhere. Convergence of cardiac nerve fibers on central pathways receiving somatic afferents from the head is likely to be responsible for the perception of cardiac ischemic pain as headache. A 47-year-old man was admitted to the emergency room of our hospital with a 2-hour history of occipital headache. Routine electrocardiography revealed monophasic ST-segment elevation in leads I and aVL and ST-segment depression in leads II, III, and aVF. During recording of lead VI, ventricular fibrillation occurred. Advanced life support was started immediately but failed to restore rhythm and cardiac function. Autopsy showed two-vessel disease with a ruptured plaque and total thrombotic occlusion of the proximal left anterior descending artery and 80% stenosis of the right coronary artery. In this patient, headache was the only symptom of myocardial ischemia. Anatomic convergence of cardiac nerve fibers on central pathways receiving somatic afferents from the head is likely to be responsible for the perception of cardiac ischemic pain as headache. Owing to the very rare occurrence of headache as a symptom of myocardial ischemia, diagnosis is difficult and requires a high...Continue Reading

Citations

Oct 12, 2010·Future Cardiology·Rui Andre Providencia
Jan 14, 2009·The Journal of Headache and Pain·Annamaria BiniPaola Torelli
Feb 6, 2007·The American Journal of Emergency Medicine·Vei-Ken SeowJiann-Ruey Ong
Dec 6, 2006·The Journal of Pain : Official Journal of the American Pain Society·Alexandre S Quevedo, Robert C Coghill
Jan 9, 2013·Headache·Luiz P Queiroz
May 29, 2008·Cephalalgia : an International Journal of Headache·J-H Wei, H-F Wang
Dec 25, 2008·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Uri SendovskiMoshe George Rothmann
Oct 6, 2010·The Open Cardiovascular Medicine Journal·Yiannis S ChatzizisisIoannis Styliadis
Feb 22, 2017·The Journal of Headache and Pain·Miao WangShengyuan Yu
Jan 26, 2021·Clinical Case Reports·Masaki TagoShu-Ichi Yamashita

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