Introduction
Methods
Results
10.6 Cardiac Cephalalgia |
---|
A. Headache, which may be severe, aggravated by exertion and accompanied by nausea and fulfilling criteria C and D |
B. Acute myocardial ischaemia has occurred |
C. Headache develops concomitantly with acute myocardial ischaemia |
D. Headache resolves and does not recur after effective medical therapy for myocardial ischemia or coronary revascularisation |
10.6 Cardiac Cephalalgia |
---|
A. Any headache fulfilling criterion C |
B. Acute myocardial ischaemia has been demonstrated |
C. Evidence of causation demonstrated by at least two of the following: |
1. headache has developed in temporal relation to the onset of acute myocardial ischaemia |
2. Either or both of the following: |
a) headache has significantly worsened in parallel with worsening of the myocardial ischaemia |
b) headache has significantly improved or resolved in parallel with improvement in or resolution of the myocardial ischaemia |
3. headache has at least two of the following four characteristics: |
a) moderate to severe intensity |
b) accompanied by nausea |
c) not accompanied by photophobia or phonophobia |
d) aggravated by exertion |
4. headache is relieved by nitroglycerine or derivatives of it |
D. Not better accounted for by another ICHD-3 diagnosis |
Patient characteristics
n (%) | |
---|---|
Sex | Male 52 (59.1%) |
Female 36 (40.9%) | |
Cardiovascular risk factors | Yes 71 (80.7%) |
No 9 (10.2%) | |
NS 8 (9.1%) | |
Headache history | Yes 5 (5.7%) |
No 17 (19.3%) | |
NS 66 (75%) | |
Headache location | |
Occipital | 19 (21.6%) |
Parietal | 3 (3.4%) |
Temporal | 13 (14.8%) |
Frontal | 12 (13.6%) |
Vertex | 2 (2.3%) |
Holocranial | 11 (12.5%) |
Eye | 2 (2.3%) |
Bregma | 1 (1.1%) |
Right lateralized headache | 1 (1.1%) |
Two or more regions | 14 (15.9%) |
NS | 10 (11.3%) |
Headache characteristics
Myocardial ischemia features
n (%) | |
---|---|
Cardiac symptoms | |
Chest pain or chest tightness | 48 (54.5%) |
Left arm pain | 6 (6.8%) |
Sweating | 23 (26.1%) |
Dyspnea | 10 (11.3%) |
Palpitations | 5 (5.7%) |
Cardiac arrest | 4 (4.5%) |
Stress test | |
Positive | 21 (23.9%) |
Negative | 2 (2.3%) |
NS | 65 (73.8%) |
Affected coronary arteries | |
RCA | 26 (29.5%) |
CXA | 17 (19.3%) |
LAD | 27 (30.7%) |
PDA | 1 (1.1%) |
Left main trunk | 2 (2.3%) |
NS | 47 (53.4%) |
ICHD-3 diagnostic criteria evaluation
Criteria | n | % |
---|---|---|
B. Acute myocardial ischemia has been demonstrated | 87/88 | 98.9% |
C1. Headache has developed in temporal relation to the onset of acute myocardial ischaemia | 64/88 | 72.7% |
C2a. Headache has significantly worsened in parallel with worsening of the myocardial ischaemia | 33/88 | 37.5% |
C2b. Headache has significantly improved or resolved in parallel with improvement in or resolution of the myocardial ischaemia | 82/88 | 93.2% |
C3a. moderate to severe intensity | 66/88 | 75% |
C3b. accompanied by nausea | 28/88 | 31.8% |
C3c. not accompanied by photophobia or phonophobia | 49/88 | 55.7% |
C3d. aggravated by exertion | 49/88 | 55.7% |
C4. Headache is relieved by nitroglycerine or derivatives of it | 40/40 | 100% |