Coronary artery disease presenting with left upper quadrant pain in a patient with chronic cervical tetraplegia

Spinal Cord Series and Cases, 2017 · DOI: 10.1038/scsandc.2017.48 · Published: July 27, 2017

Spinal Cord Injury Cardiovascular Science Trauma

Simple Explanation

This case report describes a patient with C5 tetraplegia who presented with left upper quadrant pain, which was later diagnosed as acute coronary syndrome. Patients with tetraplegia may experience atypical symptoms of cardiac issues, such as abdominal pain, making diagnosis challenging. The case highlights the importance of considering cardiac pathology in tetraplegic patients with persistent atypical symptoms, even when initial tests are inconclusive.

Study Duration

Not specified

Participants

A 65-year-old male with chronic C5 tetraplegia

Evidence Level

Level 4: Case Report

Key Findings

1
A patient with C5 tetraplegia presented with left upper quadrant pain and was diagnosed with significant coronary artery disease.
2
The patient's cardiac risk factors included age, time post-injury, sleep apnea, blood pressure variability, and limited exercise.
3
Cardiac disease can present with atypical symptoms such as abdominal pain in patients with tetraplegia, complicating diagnosis.

Research Summary

This case report describes a 65-year-old male with chronic C5 tetraplegia who presented to the emergency department with severe left upper quadrant pain and was subsequently diagnosed with acute coronary syndrome. The patient underwent coronary angiography, which revealed significant coronary artery disease requiring drug-eluting stents. His symptoms resolved post-intervention. The authors emphasize the importance of considering cardiac pathology in patients with tetraplegia presenting with atypical symptoms, even in the absence of typical cardiac risk factors.

Practical Implications

Increased Cardiac Suspicion

Maintain a high index of suspicion for cardiac pathology in patients with cervical tetraplegia presenting with atypical symptoms, particularly abdominal pain.

Collaboration is Key

Promote close collaboration between spinal cord injury services, emergency departments, and cardiology departments to ensure comprehensive patient assessment.

Early Intervention

Empower patients with SCI to seek medical review for persistent symptoms, and educate clinicians about the potential for atypical cardiac presentations in this population.

Coronary artery disease presenting with left upper quadrant pain in a patient with chronic cervical tetraplegia

Simple Explanation

Key Findings

Research Summary

Practical Implications

Increased Cardiac Suspicion

Collaboration is Key

Early Intervention

Study Limitations

Your Feedback

Was this summary helpful?

Coronary artery disease presenting with left upper quadrant pain in a patient with chronic cervical tetraplegia

Simple Explanation

Key Findings

Research Summary

Practical Implications

Increased Cardiac Suspicion

Collaboration is Key

Early Intervention

Study Limitations

Your Feedback

Was this summary helpful?