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Spinal cord infarction with cervical angina

Yoshiharu Nakae1, Ken Johkura, Yosuke Kudo

  • 1Department of Neurology, Hiratsuka Kyosai Hospital, Hiratsuka, Japan. nakae-y@kkr.hiratsuka.kanagawa.jp

Journal of the Neurological Sciences
|December 4, 2012
PubMed

Insights

Cervical angina, chest pain from cervical spine issues, can be caused by spinal cord infarction. This rare condition may affect the sympathetic nervous system, leading to symptoms like bradycardia.

Area of Science:

  • Neurology
  • Cardiology
  • Spinal Cord Medicine

Background:

  • Cervical angina is chest pain mimicking cardiac angina, originating from cervical spine disorders, often cervical spondylosis.
  • The sympathetic nervous system plays a role in cardiovascular regulation, with fibers originating from cervical and thoracic spinal cord segments.

Observation:

  • A 66-year-old man experienced chest pain and bilateral arm palsy.
  • Neurological exam revealed C7-T1 level deficits; MRI showed a spinal cord lesion, diagnosed as spinal cord infarction.
  • Severe sinus bradycardia was noted, improving over 5 weeks.

Findings:

  • Spinal cord infarction can disrupt sympathetic control, leading to bradycardia, particularly with cervical or high-thoracic lesions.
  • The patient's bradycardia suggested sympathetic system impairment at cervical and thoracic levels.
  • Cervical angina in this case was mediated via the sympathetic nervous system.

Implications:

  • This case highlights spinal cord infarction as a rare cause of cervical angina.
  • Understanding the neurological basis of cervical angina is crucial for accurate diagnosis and management.
  • Further research into the neuro-cardiac axis in spinal cord injuries is warranted.

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