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这是心肌梗死吗?一例伴有颈性心绞痛的C7神经根病病例报告。

Is it myocardial infarction? A case report of C7 cervical radiculopathy with cervical angina.

作者信息

Mashauri Harold L, Makunga Frank J, Luhwago Elisha C, Ndale Eliasa, Kilonzo Kajiru G

机构信息

Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania.

Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania.

出版信息

SAGE Open Med Case Rep. 2024 Jan 3;12:2050313X231223434. doi: 10.1177/2050313X231223434. eCollection 2024.

Abstract

Cervical radiculopathy refers to the mechanical compression or inflammation of any of the cervical roots which lead to their dysfunction. Male sex, uncontrolled diabetes mellitus, manual labor-related occupation or activities are among the possible factors which can predispose or precipitate the occurrence of cervical radiculopathy. A 63 years old male presented with cervicogenic angina which was refractory to painkillers. C7 cervical radiculopathy might present with cervicogenic angina and pose a clinical diagnosis challenge given its similarity in clinical presentation with other clinical conditions like myocardial infarction. Clinicians should have a high index of suspicion to differentiate the two conditions. Nevertheless, ruling out firstly myocardial infarction and pulmonary embolism among patients presenting with chest pain is of clinical benefit in terms of morbidity and mortality of a patient. Furthermore, proper and timely physical examination should be emphasized to be conducted to every patient so as to avoid delayed diagnosis and management.

摘要

颈神经根病是指任何颈神经根受到机械性压迫或炎症,导致其功能障碍。男性、未控制的糖尿病、与体力劳动相关的职业或活动是可能诱发或促使颈神经根病发生的因素。一名63岁男性出现了对止痛药无效的颈源性心绞痛。C7颈神经根病可能表现为颈源性心绞痛,鉴于其临床表现与心肌梗死等其他临床情况相似,会带来临床诊断挑战。临床医生应高度怀疑以鉴别这两种情况。然而,对于胸痛患者,首先排除心肌梗死和肺栓塞对患者的发病率和死亡率具有临床益处。此外,应强调对每位患者进行适当及时的体格检查,以避免延迟诊断和治疗。

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本文引用的文献

1
Cervical Radiculopathy as a Hidden Cause of Angina: Cervicogenic Angina.
J Med Cases. 2022 Nov;13(11):545-550. doi: 10.14740/jmc4025. Epub 2022 Nov 27.
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Asian Spine J. 2020 Dec;14(6):921-930. doi: 10.31616/asj.2020.0647. Epub 2020 Dec 22.
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Cervical angina: an overlooked source of noncardiac chest pain.
Neurohospitalist. 2015 Jan;5(1):22-7. doi: 10.1177/1941874414550558.
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