More IHS Resources

The International Headache Society (IHS) is the world's membership organisation for all whose professional commitment, whatever their discipline, is to helping people whose lives are affected by headache disorders.Visit the IHS website

univadis
IHS Diagnosis ICD-10
10.6 Cardiac cephalalgia [code to specify aetiology] G44.882  

Diagnostic criteria:

  1. Headache, which may be severe, aggravated by exertion and accompanied by nausea and fulfilling criteria C and D
  2. Acute myocardial ischaemia has occurred
  3. Headache develops concomitantly with acute myocardial ischaemia
  4. Headache resolves and does not recur after effective medical therapy for myocardial ischaemia or coronary revascularisation

Comment:

Diagnosis must include careful documentation of headache and simultaneous cardiac ischaemia during treadmill or nuclear cardiac stress testing. Failure to recognise and correctly diagnose 10.6 Cardiac cephalalgia can have grave consequences. Therefore, distinguishing this disorder from 1.1 Migraine without aura is of crucial importance, particularly since vasoconstrictor medications (eg, triptans, ergots) are indicated in the treatment of migraine but contraindicated in patients with ischaemic heart disease. Both disorders can produce severe head pain accompanied by nausea and both disorders can be triggered by exertion. Migraine-like headache may be triggered by angina treatment such as nitroglycerine.