心源性头痛1例  

Cardiac cephalalgia:a case report

作　　者：孙爽 方舒 曹成富[1] 卢明瑜[1] 宋俊贤[1] SUN Shuang;FANG Shu;CAO Cheng-fu;LU Ming-yu;SONGJun-xian(Department of Cardiology,Center for Cardiovascular Translational Research,Beijing Key Laboratory of Early Prediction and Intervention of Acute Myocardial Infarction,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院心血管内科,心血管转化医学研究中心,急性心肌梗死早期预警和干预北京市重点实验室,北京100044

出　　处：《中国介入心脏病学杂志》2024年第7期413-417,共5页Chinese Journal of Interventional Cardiology

摘　　要：心源性头痛是由潜在的冠状动脉病变所致,表现为头痛伴或不伴胸部症状的罕见疾病。头痛症状常常由于牵涉痛、心肌缺血引起的颅内压升高、大量致痛的神经化学介质释放和脑皮质灌注不足引起。鉴于该疾病总体患病率低、缺乏冠心病典型的胸痛表现,且可能与神经系统疾病引发的头痛难以鉴别,常常造成疾病准确诊断和治疗的延误。现报道1例仅表现头痛的急性冠状动脉综合征患者,通过经皮冠状动脉介入治疗完成血运重建,并给予标准的二级预防药物治疗。术后随访至今6个月,活动耐量较前明显提高,未再发作头痛。本病例报道旨在提高对心源性头痛患者的认识,以期早期识别并及时干预,最终改善症状和预后。Cardiac cephalalgia is a rare disease caused by underlying coronary artery disease that presents as headache with or without chest symptoms.Headache symptoms are often caused by referred pain,increased intracranial pressure and release of large amounts of paincausing neurochemicals due to myocardial ischemia,and cortical hypoperfusion.Due to the low overall prevalence of the disease,the lack of chest pain typical of coronary heart disease,and the fact that it may be difficult to distinguish from headaches caused by neurological diseases,accurate diagnosis and treatment of the disease are of ten delayed.We report a case of acute coronary syndrome with headache only.Revascularization was achieved through percutaneous coronary intervention therapy,followed by standard secondary prevention pharmacotherapy.Follow-up six months postoperatively showed a significant improvement in exercise tolerance,with no further headache episodes.The purpose is to improve the understanding of patients with cardiac cephalalgia,with a view to early identification and timely intervention,and ultimately improve the symptoms and prognosis.

关 键 词：心源性头痛 心肌缺血 心肌梗死 介入治疗 

分 类 号：R54[医药卫生—心血管疾病]