Scientific Sessions 2024  /  Pioneering Approaches to Arterial and Emergency Conditions  /  Heartfelt Headaches: Exploring Cardiac Cephalgia as an Etiology of Headaches
Logo

American Heart Association

  179
  0

Final ID: Mo4045

Heartfelt Headaches: Exploring Cardiac Cephalgia as an Etiology of Headaches

Abstract Body (Do not enter title and authors here):
Introduction: Cardiac cephalgia is an under-recognized type of headache.
Description of Case: A 68-year-old female with past medical history of chronic headaches presents with one week of non-radiating central chest pain, exertional dyspnea, palpitations, lightheadedness, and worsening headaches. The headaches were described as a “stabbing and throbbing” pain starting at the vertex and radiating anteriorly. Triggers included stress, and associated symptoms included photophobia and nausea. An electrocardiogram was notable for new T-wave inversions in the inferior leads. An echocardiogram demonstrated an ejection fraction of 44% with regional akinesis of the inferior and inferolateral walls. Patient proceeded for left heart catheterization, which depicted total occlusion of the middle segment of the right coronary artery; a stent was successfully placed and dual antiplatelet therapy was initiated. Following stent placement, she endorsed resolution of her chronic headaches and has not had recurrence.
Discussion: This case presents a patient with chronic headaches, initially diagnosed as migraines and occipital neuralgia. She had previously been treated with triptans and botulinum toxin without effect. Resolution of her headaches following revascularization suggest that cardiac cephalgia may be the underlying etiology. Cardiac cephalgia is a secondary headache disorder that is related to cardiac ischemia. It has classically been described as a headache that is triggered by exertion or stress and alleviated by rest or nitrates. Pathophysiology is incompletely understood but current theories include referred pain, simultaneous constriction of cerebral and coronary vessels, reduced cardiac output resulting in increased cardiac pressures and therefore decreased venous return from the brain, and cardiac ischemia-induced neurotransmitter release leading to cerebral vasodilation. The diagnosis of this condition is supported by a temporal relationship between coronary ischemia and headache onset. Interestingly, this patient had a headache onset several months before exhibiting signs of coronary ischemia but had an acute worsening at the time of presentation. It is important to keep cardiac cephalgia on the differential for patients with headaches in order to prevent treatment with agents, such as triptans and ergot derivatives, that are contraindicated in coronary artery disease.
  • Amin, Sheena  ( Dartmouth Health , Lebanon , New Hampshire , United States )
  • Rashid, Khaldoon  ( Dartmouth Health , Lebanon , New Hampshire , United States )
  • O'gorman, Brendan  ( Dartmouth Health , Lebanon , New Hampshire , United States )
  • Storms, Daniel  ( Dartmouth Health , Lebanon , New Hampshire , United States )
    • Author Disclosures:
    Sheena Amin: DO NOT have relevant financial relationships | Khaldoon Rashid: DO NOT have relevant financial relationships | Brendan O'Gorman: DO NOT have relevant financial relationships | Daniel Storms: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Pioneering Approaches to Arterial and Emergency Conditions

Monday, 11/18/2024 , 01:30PM - 02:30PM

Abstract Poster Session

More abstracts on this topic:
Central Vascular Implication in Neurocognitive Functioning among Men Living with and without HIV

Jones Ray, Palella Frank, Mimiaga Matthew, Witt Mallory, Peven Jamie, Haberlen Sabina, Aziz Mariam, Thorpe Roland, Levitan Emily, Buford Thomas, Blair Jessica, Causey Pruitt Zenoria, Hankes Michael, Vance David, Willig Amanda, Huck Daniel, Post Wendy, Masters Mary

Cardiac Injury Potentially Contributes to Neuroinflammation via Extracellular Vesicles

Li Qingxuan, Dhyani Neha, Gao Lie, Rudebush Tara, Zucker Irving, Tian Changhai

More abstracts from these authors:
Ventricular Support Use and Mortality Rates in Cardiogenic Shock Between 2018-2023: A Report from the Northern New England Cardiovascular Disease Study Group

Rashid Khaldoon, Lin Isabelle, Lutz Daniel, Devries James

Navigating the Management of a Saphenous Vein Graft Aneurysm: A Case Report on Conservative Medical Management and Discussion of Treatment Options

Jin Annie, Rashid Khaldoon, Kumar Sumit, Waltman Jonathan

You have to be authorized to contact abstract author. Please, Login
Not Available