Acta Neurol Belg. 2026 Aug 30. doi: 10.1007/s13760-026-03177-8. Online ahead of print.
ABSTRACT
BACKGROUND: Cardiac cephalalgia is a type of secondary headache that occurs in association with myocardial ischemia. It may present without typical chest pain, complicating early diagnosis and delaying optimal treatment. This study aims to evaluate the frequency of headache in a selected cohort of patients with myocardial infarction undergoing coronary angiography.
METHODS: We retrospectively reviewed 115 patients diagnosed with MI who underwent coronary angiography. The presence of headache prior to angiography was recorded, and follow-up was performed to assess its persistence after intervention. Statistical analyses included Chi-square, Mann-Whitney U and McNemar tests to evaluate associations between headache and clinical/laboratory parameters.
RESULTS: A total of 90 patients were included in the study (mean age 57.8 years; 71 males). Among them, 27 patients (30%) experienced headache prior to angiography. Following coronary intervention, headache persisted in only one patient, indicating a statistically significant reduction (p < 0.001). No significant relationship was found between headache presence and MI type (STEMI vs. NSTEMI), age, LDL cholesterol, blood pressure or other clinical parameters (p > 0.05).
CONCLUSIONS: Cardiac cephalalgia may be an overlooked presentation of myocardial infarction, occurring in a subset of patients. The complete resolution of symptoms following revascularization underscores the need to consider cardiac cephalalgia in the differential diagnosis of unexplained headaches, especially in the absence of classic cardiac symptoms. Greater clinical awareness could improve early diagnosis and patient outcomes.
PMID:42669089 | DOI:10.1007/s13760-026-03177-8
