Severe explosive headache: A sole presentation of acute myocardial infarction in a young man

Shin Kong Wu Ho-Su Memorial Hospital, T’ai-pei, Taipei, Taiwan
American Journal of Emergency Medicine (Impact Factor: 1.27). 03/2007; 25(2):250-1. DOI: 10.1016/j.ajem.2006.11.014
Source: PubMed
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    ABSTRACT: The initial recognition of acute myocardial infarction at the time of the emergency department (ED) visit may be difficult in the absence of typical presentations such as chest pain, diaphoresis, and radiation tenderness. Headache angina, although reported in several instances in the past with variable patient outcomes, is still an uncommon phenomenon in patients with acute myocardial infarction. We report a patient with inferior myocardial infarction who presented to the ED with a complaint of severe headache and subsequent cardiogenic shock secondary to ventricular fibrillation.
    The American journal of emergency medicine 04/2008; 26(3):387.e1-2. DOI:10.1016/j.ajem.2007.07.029 · 1.27 Impact Factor
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    ABSTRACT: Diagnosis of myocardial infarction or acute coronary syndrome is difficult, especially in atypical presentation at an emergency department, and sometimes results in serious legal issues. Symptoms of atypical presentation include shortness of breath, dyspnoea on exertion, toothache, abdominal pain, back pain and throat pain. As of now, reports of a headache, especially exertional headache, as the only presentation of acute cardiac ischaemia are rare and only have case reports. We present two patients with a cardiac source of headache and analyse 32 patients with similar situations from MEDLINE search from 1966 to the present. Cardiac cephalalgia is benign in general, but potential risks for death should be considered. If the patient has increased risk of atherosclerosis with exertional headache, anginal headache should be highly suspected and further work-up should be undertaken.
    Cephalalgia 08/2008; 28(8):892-6. DOI:10.1111/j.1468-2982.2008.01590.x · 4.89 Impact Factor
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    ABSTRACT: This article discusses headaches secondary to disorders of homeostasis, which include headaches attributed to (1) hypoxia and/or hypercapnia (high-altitude, diving, or sleep apnea), (2) dialysis, (3) arterial hypertension (pheochromocytoma, hypertensive crisis without hypertensive encephalopathy, hypertensive encephalopathy, preeclampsia or eclampsia, or autonomic dysreflexia), (4) hypothyroidism, (5) fasting, (6) cardiac cephalalgia, and (7) other disorder of homeostasis. Clinical features and diagnosis as well as therapeutic strategies are discussed for each headache type.
    Current Pain and Headache Reports 09/2008; 12(4):292-5. DOI:10.1007/s11916-008-0049-7 · 2.26 Impact Factor
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