J Clin Neurol.  2010 Jun;6(2):99-101. 10.3988/jcn.2010.6.2.99.

A Case of Cardiac Cephalalgia Showing Reversible Coronary Vasospasm on Coronary Angiogram

• Yang Y
• Jeong D
• Jin DG
• Jang IM
• Jang Y
• Na HR
• Kim S

• KMID: 2287640
• DOI: http://doi.org/10.3988/jcn.2010.6.2.99

Abstract

BACKGROUND
Under certain conditions, exertional headaches may reflect coronary ischemia.
CASE REPORT
A 44-year-old woman developed intermittent exercise-induced headaches with chest tightness over a period of 10 months. Cardiac catheterization followed by acetylcholine provocation demonstrated a right coronary artery spasm with chest tightness, headache, and ischemic effect of continuous electrocardiography changes. The patient's headache disappeared following intra-arterial nitroglycerine injection.
CONCLUSIONS
A coronary angiogram with provocation study revealed variant angina and cardiac cephalalgia, as per the International Classification of Headache Disorders (code 10.6). We report herein a patient with cardiac cephalalgia that manifested as reversible coronary vasospasm following an acetylcholine provocation test.

Keyword

cardiac cephalalgia; angina pectoris; headache

MeSH Terms

Acetylcholine
Adult
Angina Pectoris
Cardiac Catheterization
Cardiac Catheters
Coronary Vasospasm
Coronary Vessels
Electrocardiography
Female
Headache
Headache Disorders
Humans
Ischemia
Nitroglycerin
Spasm
Thorax
Acetylcholine
Nitroglycerin

Figure

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  Fig. 1 Coronary angiogram findings of patient. A: Normal finding of the right coronary artery. B: Vasospasm of the right coronary artery in response to an intra-arterial injection of acetylcholine (provocation test). C: Recovery state of the right coronary artery following intra-arterial administration of nitroglycerine.

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