Thunderclap Headache as the Presenting Symptom of Myocardial Infarction


  • Susan Broner MD,

  • Christine Lay MD,

  • Lawrence Newman MD,

  • Michael Swerdlow MD

  • From The Headache Institute, New York (Drs. Broner, Lay, Newman); and Montefiore Medical Center, Department of Neurology, Bronx, New York (Dr. Swerdlow).

Address all correspondence to Susan W. Broner, MD, St. Luke's-Roosevelt Hospital, Headache Institute, 1000 Tenth Avenue Suite 1C-10, New York, NY 10019.


Headache as the presenting symptom of myocardial ischemia has been reported in more than 20 cases. These headaches have been described as of gradual onset, associated with exertion and with EKG changes. We present herein the first case of thunderclap headache occurring at rest as the sole symptom of an acute myocardial infarction.