What's drug of choice in pat. with acute migraine and ischemic heart disease?

Beat blockade: Drugs with beta blockade effect (inderal, atenolol, etc) can be useful for pat as well as migraines and heart issues.

Thanks for asking!: This is a tough situation. You cannot use either triptans or ergots. So may have to use nasaids, fioricet, (acetaminophen butalbital and caffeine) or so.

Agree with Dr Wang: Avoid all triptans, but why not just prevent the headaches, and this can be done with ongoing acupuncture, Botox injections, and even regular ingestion of otc items such as riboflavin, co-q10, butterbur, feverfew, ?Magnesium. A headache specialist could design a specific program.