Migraine and Echocardiography

E-chocardiography Journal: Alphabetical List / Chronological List / Images / Home Page

The migraine patient may present with aura without headache, occasionally mimicking a transient ischemic attack. The unilateral sensory loss, hemiparesis, or dysphasia may prompt referral to echocardiography to rule out a cardiac source of embolus.

The following references discuss a possible pathophysiological relationship between migraine and mitral valve prolapse:

  1. Herman P. Migraine and mitral valve prolapse.
    Archives of Neurology 46(11):1165, 1989 Nov.
  2. Herman P. Migraine, large pupils, mitral valve prolapse and emotional disturbances: an autonomic disorder.
    Headache 27(6):340-4, 1987 Jun.
  3. Pfaffenrath V, Pollmann W, Autenrieth G, Rosmanith U. Mitral valve prolapse and platelet aggregation in patients with hemiplegic and non-hemiplegic migraine.
    Acta Neurologica Scandinavica 75(4):253-7, 1987 Apr.
    Migraine and mitral valve prolapse (MVP) share a number of features. Both migraine and MVP show platelet dysfunctions and an increased risk of transient ischemic attacks (TIA) and stroke. There is a strikingly high incidence of migraine among MVP patients. The focal neurological deficits associated with hemiplegic migraine resemble TIA symptoms which may occur in MVP patients. Furthermore, the risk of cerebral infarction in migraineurs is reported to be higher than in the general population. The results of this study with 43 patients suffering from non-hemiplegic migraine (common and classical migraine) and 19 migraineurs with a hemiplegic migraine indicate that hemiplegic migraine is not associated with MVP and increased platelet aggregation more frequently than other migraine forms. Independent of migraine type, there is no difference between patients with and without mitral valve prolapse with respect to platelet dysfunction.

  4. Lanzi G, Grandi AM, Gamba G, Balottin U, Barzizza F, Longoni P, Fazzi E, Venco A. Migraine, mitral valve prolapse and platelet function in the pediatric age group.
    Headache 26(3):142-5, 1986 Mar.
  5. Spence JD, Wong DG, Melendez LJ, Nichol PM, Brown JD. Increased prevalence of mitral valve prolapse in patients with migraine.
    Canadian Medical Association Journal 31(12):1457-60, 1984 Dec 15
    Patients with classic migraine (69 women and 31 men)selected randomly from a practice list of over 1000 were matched for age, sex and neighbourhood with 100 people who did not have headache problems, and both groups underwent M-mode and two-dimensional echocardiography and clinical examination by cardiologists blinded to the subjects' clinical status. The mean ages were 34.9 +/- 11.3 years for the migraine group and 33.1 +/- 9.9 years for the control group. Definite and possible mitral valve prolapse (MVP), diagnosed according to predefined echocardiographic criteria, were found about twice as often in the migraine group as in the control group in 15 v. 7 and 16 v. 8 patients respectively); the echocardiograms were definitely normal in 69 migraine patients and 85 controls (chi 2 = 8.39, p less than 0.025). Altogether 25% of the migraine group and 11% of the control group had evidence of MVP from a combination of the echocardiographic and auscultatory findings (chi 2 = 5.72, p less than 0.025). The odds ratio was 2.7, with 95% confidence limits of 1.17 and 6.29. The association between migraine and MVP has implications for the understanding of platelet abnormalities and episodes of cerebral ischemia occurring in both these conditions.

  6. Gamberini G, D'Alessandro R, Labriola E, Poggi V, Manzoni GC. Carpeggiana P, Sacquegna T. Further evidence on the association of mitral valve prolapse and migraine.
    Headache 24(1):39-40, 1984 Jan.
  7. Amat G, Louis PJ, Loisy C, Centonze V, Pelage S. Migraine and the mitral valve prolapse syndrome.
    Advances in Neurology 33:27-9, 1982.
  8. Da Silva DC, Lechevalier B, Le Clerc A, Ollivier D. Migraine and prolapse of the lesser cusp of the mitral valve.
    Revue d Oto-Neuro-Ophtalmologie 53(4):311-5, 1981 Jul-Sep.
  9. Litman GI, Friedman HM. Migraine and the mitral valve prolapse syndrome.
    American Heart Journal 96(5):610-4, 1978 Nov.
    The authors of this 1978 article believe there is a significant association between migraine and the mitral valve prolapse. Propranolol is proposed as the drug of choice in these patients for the treatment and prevention of migraine. Increased platelet aggregability is postulated to be the common pathophysiologic mechanism as relates to emboli from the valve and possibly in strokes related to migraine.

Back to E-chocardiography Home Page.