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a Cardiac cephalalgia attacks provoked by Prinzmetal angina - a case report

A 51-year-old man with no past medical history of headache or risk factors for vascular diseases was diagnosed with supraventricular tachycardia (SVT) in 2005. In 2014 SVT attacks were longer and always followed by severe headache attacks. Accompanying symptoms were dizziness, non-rotational vertigo, confusion, episodes of double vision and tinnitus; these symptoms would last one day, followed by severe tiredness for 2 days. Neurologic and cardiologic evaluation as well as extensive diagnostic test between the attacks was normal. Catheter coronarography showed no stenoses but did show spasms in distal left anterior descending artery. A remarkable effect on SVT and headaches was shown after the introducement of diltiazem. The diagnosis cardiac cephalalgia (CC) was established. As our case report is unique, we hope that our observations will help cardiologists and neurologists to better understand and treat patients with CC. CC should be distinguished from migraine, to avoid prescribing triptans and vasoconstrictors.