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Spinal cord infarction mimicking angina pectoris.

¹Department of Neurology, Mayo Clinic, Jacksonville, Fla 32224, USA.

Mayo Clinic Proceedings

|November 15, 2000

Summary

Cervical spinal cord infarction can cause severe chest pain that mimics heart attack symptoms. This spinal stroke, specifically at the C6-7 level, affects nerves connected to the heart, leading to referred pain.

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Area of Science:

Neurology
Cardiology
Spinal Cord Medicine

Background:

Chest pain is a common symptom that often leads to cardiac investigations.
Acute myocardial infarction is a primary concern for patients presenting with chest pain.

Observation:

A 42-year-old man experienced severe chest pain similar to angina pectoris.
Neurologic signs developed after the onset of chest pain, delaying diagnosis.
Cardiac evaluation revealed no evidence of heart disease.

Findings:

Imaging confirmed an acute infarction in the cervical spinal cord at the C6-7 level.
This spinal cord segment is associated with afferent pathways from the cardiac plexus.
The spinal cord lesion was identified as the source of the patient's chest pain.

Implications:

Spinal cord stroke, particularly in the lower cervical region, should be considered in the differential diagnosis of chest pain.
This case highlights the potential for non-cardiac spinal pathology to mimic cardiac ischemia.
Understanding the neuroanatomy of referred pain is crucial for accurate diagnosis.

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