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Herniated cervical disk presenting as ischemic chest pain.
L C Mitchell1, R W Schafermeyer
1Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28232.
The American Journal of Emergency Medicine
|September 1, 1991
Summary
Chest pain in adults may stem from cervical disk disease, not just heart issues. Promptly rule out life-threatening conditions before considering herniated cervical disks as a cause.
Area of Science:
- Emergency Medicine
- Neurosurgery
- Cardiology
Background:
- Chest pain is a common emergency department presentation, with myocardial ischemia being the primary concern.
- Established guidelines exist for evaluating chest pain, emphasizing the exclusion of life-threatening cardiac causes.
- Cervical disk disease is an underrecognized potential cause of chest pain.
Observation:
- Two cases are presented where patients exhibited symptoms suggestive of cardiac ischemia.
- Diagnostic workup revealed herniated cervical disks as the underlying cause in both instances.
- Surgical intervention for cervical disk herniation resulted in complete symptom resolution.
Findings:
- Cervical disk herniation can mimic cardiac ischemia symptoms.
- This diagnosis was well-documented in medical literature mid-20th century but is less frequently discussed currently.
- Herniated cervical disks should be considered in the differential diagnosis of chest pain after life-threatening causes are excluded.
Implications:
- Emergency physicians should broaden their differential diagnosis for chest pain to include cervical disk disease.
- Increased awareness may lead to earlier diagnosis and appropriate treatment for patients with non-cardiac chest pain.
- Revisiting historical medical literature can uncover valuable, underutilized diagnostic insights.