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Cervical angina, or pseudoangina, mimics cardiac chest pain due to cervical disc issues compressing nerves. Diagnosis involves history, exam, and imaging, ruling out heart disease, with treatment including traction and physical therapy.
Area of Science:
- Neurology
- Orthopedics
- Cardiology
Background:
- Cervical angina is chest pain mimicking cardiac angina.
- It originates from cervical discopathy causing nerve root compression, often C7.
- This condition is also known as pseudoangina.
Observation:
- Diagnosis relies on patient history and physical examination findings.
- Symptoms can be mistaken for true angina, necessitating a thorough workup.
- Cervical discopathy is the underlying cause of nerve root compression.
Findings:
- Magnetic resonance imaging (MRI) and discography can confirm cervical discopathy.
- Ruling out coexisting coronary artery disease is crucial.
- Compression of the C7 nerve root is the most common etiology.
Implications:
- Early diagnosis and appropriate management can alleviate pain and improve quality of life.
- Non-surgical treatments include cervical traction, physical therapy, NSAIDs, and muscle relaxants.
- Referral to a spine surgeon is considered if conservative treatments fail.
Abstract:
Cervical angina is defined as chest pain that resembles true cardiac angina but originates from a cervical discopathy with nerve root compression. This condition, which is also referred to as pseudoangina, most commonly results from compression of the C7 nerve root. Several simple findings from the history and the physical examination help make the diagnosis, which can then be confirmed with magnetic resonance imaging and/or discography. Coexisting coronary artery disease must always be ruled out. Treatment includes intermittent cervical traction, physical therapy, nonsteroidal anti-inflammatory drugs and muscle relaxants. If these measures fall to alleviate the patient's pain, referral to a spine surgeon may be indicated.