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Spinal cord infarction with cervical angina
- Source :
- Journal of the neurological sciences. 324(1-2)
- Publication Year :
- 2012
-
Abstract
- Cervical angina is defined as chest pain resembling true cardiac angina but originating from disorders of the cervical spine. Cervical angina is caused by cervical spondylosis in most cases. A 66-year-old man presented with bilateral arm palsy after chest pain resembling angina pectoris. Neurological examination revealed motor and sensory disturbances of the C7 to T1 level, and magnetic resonance imaging showed a hyperintense spinal cord lesion on T2-weighted imaging. Spinal cord infarction was diagnosed. Severe sinus bradycardia was identified on admission, and improved over the course of 5 weeks. Sympathetic afferent fibers from the heart and coronary arteries generally have their cell bodies in the dorsal root ganglia of the C8 to T9 spinal segments. Electrical stimulation of cardiopulmonary afferent fibers excites spinothalamic tract cells in the T1 to T6 segments of the spinal cord. Spinal cord injury can result in the loss of supraspinal control of the sympathetic system and can cause bradycardia, as commonly seen in patients with severe lesions of the cervical or high-thoracic (T6 or above) spinal cord. Bradycardia in the present case suggested impairment of the sympathetic system at the cervical and thoracic levels. These findings indicated that cervical angina in this case was mediated through the sympathetic nervous system. This represents only the second report of cervical angina caused by spinal cord infarction.
- Subjects :
- Male
medicine.medical_specialty
Spinothalamic tract
Sympathetic nervous system
Chest Pain
Chest pain
Spinal Cord Diseases
Angina Pectoris
Angina
Electrocardiography
Troponin T
Internal medicine
Cervical spondylosis
Bradycardia
Medicine
Humans
cardiovascular diseases
Spinal cord injury
Aged
Neurologic Examination
business.industry
medicine.disease
Spinal cord
Magnetic Resonance Imaging
medicine.anatomical_structure
Neurology
Infarction
Anesthesia
Cardiology
Neurology (clinical)
Ischemic chest pain
medicine.symptom
business
Subjects
Details
- ISSN :
- 18785883
- Volume :
- 324
- Issue :
- 1-2
- Database :
- OpenAIRE
- Journal :
- Journal of the neurological sciences
- Accession number :
- edsair.doi.dedup.....6655504fdaeca8d5bbe84be1318c7273