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Case Reports
. 2011;38(4):433-6.

Coronary slow flow and acute coronary syndrome in a patient with spinal cord injury

Meryem Aktoz  1 , Ersan Tatli, Ahmet Barutcu, Flora Ozkalayci, Elif Umit, Armagan Altun
Affiliations
Case Reports

Coronary slow flow and acute coronary syndrome in a patient with spinal cord injury

Meryem Aktoz et al. Tex Heart Inst J. 2011.

Abstract

We report the case of a 55-year-old man who presented with acute coronary syndrome due to coronary slow flow after spinal cord injury. Data regarding the causes and clinical manifestations of coronary slow flow are inconclusive, but the autonomic nervous system is believed to be at least a contributing factor. The predominant vagal activity causes vasodilation and hemostasis, which can lead to acute coronary syndrome. We hereby call attention to hyperactive parasympathetic tonicity, which can lead to coronary slow flow and acute coronary syndrome in acute spinal cord injury patients.

Keywords: Acute coronary syndrome; autonomic dysreflexia; coronary circulation; coronary slow flow; spinal cord injuries/complications.

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Figures

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Fig. 1 Magnetic resonance imaging reveals a high-signal area (large arrow) indicative of spinal cord injury at the C3 through C6 levels.
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Fig. 2 A) Electrocardiogram shows ST-segment alteration in leads V1 through V4 during absence of chest pain. B) Electrocardiogram shows ST-segment elevation in leads V1 through V4 during presence of chest pain.
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Fig. 3 A) Coronary angiogram (right anterior oblique projection) reveals no significant stenosis, together with coronary slow flow in the left anterior descending coronary artery. B) Coronary angiogram reveals no significant stenosis in the right coronary artery. C) Coronary angiogram (right anterior oblique cranial projection) reveals no significant stenosis, together with coronary slow flow in the left anterior descending coronary artery. Real-time motion images are available at www.texasheart.org/journal.
See this image and copyright information in PMC

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