Heart spasms and headaches

I was told I have a slight heart murmur. I've also noticed I get heart spasms throughout the day, sometimes every few minutes. It feels like my heart skips a beat and I have to take a deep breath. Right after the spasm, I get a pain that shoots up into my head and my head throbs, then sometimes I have a bad headache for a while. Do you have any idea what this is or what causes it? Is there anything I can do to make it stop?

Thank you! Taki

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

First of all, you should discuss your heart condition with a cardiologist. You may need a holter monitor to evaluate your heart “spasms”. You may also need a surface echo to evaluate the structures of your heart. Also, it is important to remember that anxiety is a psychological and physiological condition with a multitude of symptoms, including heart palpitations, muscle tension, fatigue, nausea, chest pain, shortness of breath, headaches, and GI symptoms such as diarrhea to name a few. Anxiety can also be accompanied with panic attacks such as a feeling of impending doom or death. With regards to the headache, there is a hotly debated topic in neurology of whether or not a patent foramen ovale (PFO), which is a defect between the two atria of the heart, is associated with migraines. PFO’s are quite common in the population as are migraines. It is difficult to determine if they are related because of their prevalence.

Migraines are a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. Treatment for migraines is two-fold: preventative and abortive. Preventative therapy is a medication that would be taken every day regardless of whether or not a headache is prevent. This type of medication is used to prevent headaches from occurring, and there are several types including but not limited to beta blockers such as propranolol, calcium channel blockers such as verapamil, and others including topamax, depakote, elavil, etc. A lot of these medications were invented for other uses and are used not only for headache but also epilepsy and depression. They have proven very effective in preventing headaches. The second medication is abortive, meaning it is used when a headache is coming on. The medication used depends on the nature of a headache. If it is a migraine type headache, a group of medications called triptans can be used. However, with frequent use of abortive medications including triptans, tylenol, advil, and others, medication overuse headache occurs. This requires a specific treatment in which the over-used medications are slowly stopped and replaced with more long-acting medications. Tylenol with caffiene, and similar medications, can cause medication overuse headache if used too frequently. Lyrica, which is used for fibromyalgia, can be used for chronic headaches.

I suggest you follow up with a neurologist in your local area. You should also see a cardiologist. It will be important to determine what type of headache your having in order to determine appropriate treatment.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.