Walker W C, Khokhar M S
Department of Rehabilitation Medicine, Medical College of Virginia, Richmond 23298-0677.
Arch Phys Med Rehabil. 1992 Jan;73(1):91-4.
The management of ischemic heart disease in patients with chronic spinal cord injury (SCI) will become an increasingly major concern as this population ages. Although silent ischemia has become an important topic in the medical literature, the relationship with cervical SCI has not been adequately explored. A literature search revealed no case reports of documented asymptomatic cardiac ischemia in SCI patients. This is a case report of a 65-year-old patient with chronic C7 incomplete SCI who had multiple risk factors for coronary artery disease and an abnormal electrocardiogram. Despite being completely asymptomatic, the patient was found to have significant myocardial ischemia induced by minimal stress using atrial paced thallium scintigraphy. This finding led to the cancellation of an elective surgical procedure. This case illustrates the importance of suspecting silent myocardial ischemia in cervical SCI patients.
随着慢性脊髓损伤（SCI）患者群体的老龄化，缺血性心脏病的管理将成为日益重要的关注点。尽管无症状性缺血已成为医学文献中的一个重要话题，但与颈髓损伤的关系尚未得到充分探讨。文献检索未发现脊髓损伤患者有记录的无症状性心脏缺血的病例报告。这是一例65岁慢性C7不完全性脊髓损伤患者的病例报告，该患者有多种冠状动脉疾病危险因素且心电图异常。尽管完全无症状，但使用心房起搏铊闪烁扫描发现该患者在轻微应激下有明显的心肌缺血。这一发现导致择期手术取消。该病例说明了怀疑颈髓损伤患者存在无症状性心肌缺血的重要性。
