Cardiac cephalalgia: a narrative review and ICHD-3 criteria evaluation

María Pilar Navarro-Pérez*, Elena Bellosta-Diago, Jes Olesen, Sonia Santos-Lasaosa

*Corresponding author for this work

Research output: Contribution to journalReviewResearchpeer-review

4 Citations (Scopus)
13 Downloads (Pure)

Abstract

Background: Cardiac cephalalgia is an unusual condition that occurs during an episode of myocardial ischemia. Information about cardiac cephalalgia is scarce and its characteristics and physiopathology remain unclear. Our aim is to provide a narrative review of clinical characteristics and physiopathology of cardiac cephalalgia and to evaluate the current diagnostic criteria. Methods: A search through PubMed was undertaken for studies on cardiac cephalalgia published until 20th September 2022. We summarized the literature and provide a comprehensive review of the headache characteristics and possible mechanisms. We also evaluated current International Classification of Headache Disorders third edition diagnostic criteria based on prior reported cases. Results: In total, 88 cases were found. Headache characteristics were variable. Occipital location and throbbing pain were the most frequently reported. Headache was accompanied in most cases by cardiac symptoms. Criterion B was fulfilled by 98% of cases, criterion C1 by 72%, and criteria C2a and C2b by 37 and 93.2%, respectively. Regarding headache features described in diagnostic criterion C3, ‘moderate to severe intensity’, ‘accompanied by nausea’, ‘not accompanied by photophobia or phonophobia’ and ‘aggravated by exertion’, were reported in 75, 31, 55 and 55% of cases, respectively. Conclusion: Cardiac cephalalgia characteristics are variable and the headache features described in the diagnostic criterion C3 might not be adequate. Given that cardiac cephalalgia can be the manifestation of a life-threatening condition it is important to increase the knowledge about this entity.

Original languageEnglish
Article number136
JournalJournal of Headache and Pain
Volume23
Number of pages9
ISSN1129-2369
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Exertional headache
  • Headache
  • Myocardial infarction
  • Myocardial ischemia
  • Secondary headache

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