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A small study has emphasised that migraines may have more than one source, after finding a link with random congenital heart disease defects in adults, not just right to left shunt, as previously accepted.
Prevalence of migraines, particularly those with aura, was significantly higher for patient groups with obligate right to left shunt or random congenital heart defect compared with a general practice population but not between groups with congenital defects with or without obligate right to left shunt. A link was also found between raised haemoglobin concentration and migraine, leading researchers to suggest that migraine caused by raised haemoglobin concentration, as seen elsewhere, might occur through activation of blood compounds and endothelium by shear stress.
The three groups comprised 40 patients, each age and sex matched, all aged over 16 years without Down syndrome or mental retardation. Patients with obligate right to left shunt were selected first from a database of patients with congenital heart disease and matched with patients from the entire database and with others from general practice. Migraine with or without aura was diagnosed by a neurologist from patients' self completed questionnaires, according to internationally recognised criteria.
One other report has suggested a link between migraine and congenital heart defects generally, but right to left shunt has been the focus of attention previously.
Hermans H, et al. Heart 2007;93:361–362.
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Copyright © 2007 BMJ Publishing Group Ltd