Coronary vasospasm in intractable autonomic dysreflexia.
See Wei Tan1, Zafefe Ba Rahman1, Aishah A Fauzi2
1Department of Rehabilitative Medicine, University Malaya Medical Centre , Kuala Lumpur, Malaysia.
Spinal Cord Series and Cases
|January 6, 2017
Summary
Autonomic dysreflexia in spinal cord injury (SCI) patients may trigger coronary vasospasm, leading to silent myocardial ischemia. This rare case highlights the link between uncontrolled sympathetic nervous system activity and cardiac events in SCI.
Area of Science:
- Cardiology
- Neurology
- Spinal Cord Injury Research
Background:
- Coronary vasospasm causes myocardial ischemia, infarction, arrhythmia, and sudden death.
- Most coronary spasm patients have underlying cardiac pathology.
Purpose of the Study:
- To present a rare case of autonomic dysreflexia with silent myocardial ischemia secondary to coronary vasospasm.
- To explore the link between autonomic dysreflexia and coronary vasospasm in spinal cord injury (SCI).
Main Methods:
- Case report of a 36-year-old patient with chronic C5 paraplegia and autonomic dysreflexia.
- Utilized MRI perfusion study to assess cardiac function and coronary arteries.
Main Results:
- The patient presented with silent myocardial ischemia due to coronary vasospasm without underlying cardiac pathology.
- MRI revealed normal left ventricular contractility and no coronary artery occlusion.
Conclusions:
- Autonomic dysreflexia may predispose to coronary vasospasm via sympathetic nervous system overactivity.
- Sensory input disruption in SCI patients can lead to asymptomatic myocardial ischemia.
- Highlights diagnostic and management challenges of coronary vasospasm associated with autonomic dysreflexia.
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