Work

Cardiac cephalalgia-headache as an atypical presentation of ST-segment elevation myocardial infarction: a case report

Year: 2025

Type: article

Abstract: BACKGROUND: Ischaemic heart disease commonly presents with chest pain and autonomic symptoms; however, atypical manifestations can occur. Cardiac cephalalgia is a rare presentation of acute coronary syndrome, characterised by a migraine-like headache triggered by myocardial ischaemia. Diagnosis requires a high index of suspicion. CASE PRESENTATION: We describe a 47-year-old man with diabetes and a history of smoking who presented with an acute, severe frontotemporal headache accompanied by nausea and vomiting. Electrocardiography revealed ST-segment elevation in the inferior leads. Coronary angiography demonstrated multivessel coronary artery disease involving the right coronary artery and the left anterior descending artery. A subsequent measurement of serum troponin I confirmed myocardial injury. Both arteries were successfully stented, leading to clinical improvement and resolution of the headache. CONCLUSIONS: This case highlights the importance of considering cardiac causes in patients presenting with severe headaches particularly in those with cardiovascular risk factors.

Source: BMC Cardiovascular Disorders

DOI: 10.1186/s12872-025-04898-z

Authors: Udayanga Andadola, Subhani Poornima, Gamini Galappatthy

Institutions: Sabaragamuwa University of Sri Lanka, National Hospital of Sri Lanka

Language: English

Topic: Acute Myocardial Infarction Research

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090