Recently an article reported that a hard to recognize symptom of heart attack may be headache.

What surprised me was the mention that headache may be the only reason the patient presents to the doctor or to the Emergency Room. Echoed in this PubMed article which says, "Myocardial infarction presenting solely as an acute, severe headache is underdiagnosed in elderly patients." It is the elderly who most often present with atypical symptoms other than chest pain.

Time is the critical factor when dealing with heart issues. This article left me wondering about the delay that I would expect happens to those who present with "only a headache".

Most migraineurs, and indeed anyone suffering debilitating headache disorders have had to make doctor's office or Emergency Department visits as a result of either the pain or other disabling symptoms that often accompany their attacks. Such intense pain may include but is not limited to nausea and vomiting, dehydration, or even pain so intensely unbearable that the patient has threatened or attempted suicide. Most patients waited until desperation has set in to begin the ER odyssey. Sadly, many patients with these kinds of debilitating attacks have had the occasion to run into a member of the staff who will be heard making the statement,

"It's only a headache."

Unfortunately I've had this happen to me personally on more than one occasion. Either the statement is overheard, mentioned by those casually speaking nearby, or straight from the uninformed nurse or doctor in the room. Unfortunately, some doctors still consider headache patients GOMER's (Get Out of My ER) and treat- or not- accordingly.

Only on occasion has anyone listened to my heart, and only once or twice noticed the murmur I know is there. This leaves me to wonder, if a Migraineur walks into the ER with "another headache", what are the chances they will be seriously checked for a heart-related issue? If they are checked but are without the 'normal' presenting symptoms of a cardiac problem, will their heart condition be noticed before it is too late?

Further digging leads me to several articles related to Headache Angina, while infrequent, was "...reported in several instances in the past with variable patient outcomes...". Heart attack presenting primarily with headache two cases which were unfortunately fatal, and Angina associated with Migraine .

Other studies have shown that although there is a definite correlation between Migraine and Angina possibly related to vasoconstriction of the coronary arteries, Migraineurs do not have an increased risk for actual heart disease. Medical News Today. The journal Headache mentions this connection and calls for more detailed studies to identify the correlation between migraine and vasospasm.