A case of cardiac cephalalgia showing reversible coronary vasospasm on coronary angiogram.

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 ultra-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 J Clin Neurol 2010;6:99-101