Harada Taku, Nakai Mori
General Medicine, Nerima Hikarigaoka Hospital, Tokyo, JPN.
Diagnostic Generalist Medicine, Dokkyo Medical University Hospital, Mibu, JPN.
Cureus. 2023 Mar 17;15(3):e36279. doi: 10.7759/cureus.36279. eCollection 2023 Mar.
Cervical angina is a form of non-cardiac chest pain that originates in the cervical spine or cervical cord; it is an under-recognized and easily underdiagnosed condition. Patients with cervical angina often report delayed diagnosis. Here, we report the case of a 62-year-old woman with a history of cervical spondylosis and undiagnosed recurrent chest pain who presented with numbness in the left upper arm and was diagnosed with cervical angina. Although most cases of cervical angina involve uncommon self-limited diseases that improve with conservative treatment, timely diagnosis can reduce patient anxiety and unnecessary office visits and tests. The critical aspect of chest pain evaluation is to rule out fatal disease. Once fatal disease is ruled out, cervical angina should be considered in differential diagnosis if there is a history of cervical spine disease, if the pain radiates to the arm, if it is elicited by cervical spine range of motion or upper extremity movement, or if the chest pain lasts less than a few seconds.
颈源性心绞痛是一种起源于颈椎或颈髓的非心源性胸痛；它是一种未得到充分认识且容易漏诊的病症。颈源性心绞痛患者常报告诊断延迟。在此，我们报告一例62岁女性病例，该患者有颈椎病病史且反复出现未确诊的胸痛，伴有左上臂麻木，被诊断为颈源性心绞痛。虽然大多数颈源性心绞痛病例涉及不常见的自限性疾病，可通过保守治疗改善，但及时诊断可减轻患者焦虑以及避免不必要的门诊就诊和检查。胸痛评估的关键在于排除致命性疾病。一旦排除致命性疾病，如果有颈椎病病史、疼痛放射至手臂、由颈椎活动范围或上肢运动诱发，或者胸痛持续时间少于几秒，则在鉴别诊断时应考虑颈源性心绞痛。
