Lanza G A, Sestito A
Recenti Prog Med. 2001 Jul-Aug;92(7-8):467-70.
Myocardial ischemia usually results in typical anginal chest pain, but cardiac pain can occasionally only be referred to regions outside the thorax. Headache, however, is a very unusual expression of myocardial ischemia. Thus, the correct diagnosis of "cardiac headache" is difficult and requires a high dose of suspicion, but it can be crucial to avoid possible life-threatening events. The type and site of headache are not specific, but an episodic occurrence. A short duration and a relationship with exercise or emotional triggers should alert physicians on the possible cardiac origin of headache. Paradoxical relief and prevention of headache by sublingual nitrates are a strong clue to the diagnosis.
心肌缺血通常会导致典型的心绞痛性胸痛,但心脏疼痛偶尔也可能仅表现为胸部以外的部位疼痛。然而,头痛是心肌缺血非常罕见的一种表现形式。因此,正确诊断“心源性头痛”很困难,需要高度怀疑,但这对于避免可能危及生命的事件至关重要。头痛的类型和部位并无特异性,而是呈发作性。持续时间短以及与运动或情绪触发因素有关,应提醒医生注意头痛可能源于心脏。舌下含服硝酸盐可使头痛得到反常缓解和预防,这是诊断的一个有力线索。