Physiotherapy management of a patient with non-cardiac angina: A case report

Cervicogenic angina, or non-cardiac chest pain originating from cervical spine pathology, is a condition in which pain radiates from the cervical spine to the chest, often mimicking symptoms of cardiac angina. This case report describes the unique physiotherapy management of a 47-year-old male with non-cardiac angina resulting from cervical disc herniation at C5-6-7. It highlights effective treatment strategies and aims to increase awareness of physiotherapy's role in managing non-cardiac chest pain.

The patient was initially misdiagnosed with post-COVD complications, the patient presented with persistent neck and chest pain, later confirmed as cervicogenic angina through MRI and clinical assessment. His treatment involved a targeted physiotherapy program including postural education, McKenzie exercises, cervical traction, and ergonomic adjustments. Sessions were conducted twice weekly over four weeks. Assessment of the cervical range of motion (ROM) showed improvements. Following this intervention, the patient experienced symptom relief, with no recurrence at a three-month follow-up. The patient reported significant improvement in the Visual analogue scale (VAS), Manual muscle strength (MMT) and the Neck disability index (NDI).

This case highlights the potential for cervical disc herniation to mimic cardiac-related chest pain and underscores the importance of physiotherapy in managing such cases. The findings contribute to the limited literature on physiotherapy's role in treating cervicogenic angina, providing insights for practitioners in manual medicine.