The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2018.1518763 · Published: September 1, 2019
Autonomic dysreflexia (AD) involves sudden high blood pressure in those with spinal cord injuries (SCI) at T6 or above. This report presents two SCI patients with high blood pressure due to anxiety, mimicking AD. Case 1: A 77-year-old male with C4 AIS D SCI experienced a rise in systolic blood pressure (SBP) from 138 to 170 mmHg without instrumentation. His SBP returned to normal when told urodynamics would be postponed. Case 2: A 57-year-old male with T12 AIS A SCI had elevated SBP during bladder filling. After stopping the filling and informing him the study was complete, his SBP decreased.
Clinicians should consider anxiety as a potential cause of hypertension in SCI patients, especially those with a history of anxiety or undergoing stressful procedures.
Management of hypertension in SCI patients should include addressing potential anxiety triggers and providing appropriate anxiolytic interventions.
Reports of AD in patients with SCI below T6 should be re-evaluated to consider the potential role of anxiety-related hypertension.