Cefalea e malattia arteriosa coronarica

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.