Cardiac arrhythmias accompanying acute compression of the spinal cord

Evans, Delbert E.; Kobrine, Arthur I.; Rizzoli, Hugo V.

doi:10.3171/jns.1980.52.1.0052

Cited by 39 publications

(12 citation statements)

References 16 publications

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“…The immediate increase in HR in our study may have been a result of a similar catecholamine surge. In some animal models of SCI, particularly those using the balloon compression method of injury, an initial hypertensive, bradycardic response has been reported, owing to high alpha-adrenergic activity as well as a baroreflex response [35,36]. After cervical and upper thoracic SCI, unopposed parasympathetic pathways predominate and worsen hemodynamic control systems both acutely and chronically.…”

Section: Discussionmentioning

confidence: 98%

Acute Changes in Systemic Hemodynamics and Serum Vasopressin After Complete Cervical Spinal Cord Injury in Piglets

et al. 2010

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Complete cervical SCI produces hemodynamic alterations consistent with the withdrawal of sympathetic tone. Although mean arterial pressure (MAP) decreased significantly after SCI, the increase in serum vasopressin may have played a role in maintaining blood pressure and preventing circulatory collapse, a complication which is encountered frequently in patients with cervical and upper thoracic SCI.

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Section: Discussionmentioning

confidence: 98%

Acute Changes in Systemic Hemodynamics and Serum Vasopressin After Complete Cervical Spinal Cord Injury in Piglets

et al. 2010

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“…4,5 The Academy of Veterinary Cardiology sponsors this feature. 4 Injury of the afferent nerves elicits, by means of medullary reflex pathways, an immediate burst of vagal hyperactivity.…”

Section: Discussionmentioning

confidence: 99%

“…4 Injury of the afferent nerves elicits, by means of medullary reflex pathways, an immediate burst of vagal hyperactivity. 4 Injury of the afferent nerves elicits, by means of medullary reflex pathways, an immediate burst of vagal hyperactivity.…”

Section: Discussionmentioning

confidence: 99%

“…4 Injury of the afferent nerves elicits, by means of medullary reflex pathways, an immediate burst of vagal hyperactivity. 4 The Academy of Veterinary Cardiology sponsors this feature. Spinal cord injury also causes efferent sympathetic nerve injury with subsequent widespread sympathetic stimulation, which follows the initial increase in parasympathetic tone.…”

Section: Discussionmentioning

confidence: 99%

“…After an unsuccessful attempt to pass an orotracheal tube, an emergency tracheostomy was performed, and the horse was ventilated mechanically. 4,5 The Academy of Veterinary Cardiology sponsors this feature. No antiarrhythmic medications were administered because the heart rate was not excessively rapid and the horse was normotensive.…”

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confidence: 99%

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ECG of the Month

Bright¹,

Hellyer²

2002

javma

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A 16-year-old castrated male mixed-breed horse weighing approximately 500 kg (1,100 lb) was anesthetized for excision of a focal mass on the third eyelid of the left eye. The horse had no history of cardiac disease, and results of cardiac auscultation were normal before surgery. Anesthesia was achieved by use of IV administration of xylazine, guaifenesin, and ketamine, and maintained by use of inhalation of sevoflurane in oxygen. Although there were no complications during anesthetic induction or surgery, the horse was found recumbent and apneic in the recovery stall after having been extubated and seen standing. After an unsuccessful attempt to pass an orotracheal tube, an emergency tracheostomy was performed, and the horse was ventilated mechanically. An arrhythmia was detected, and an ECG rhythm strip was recorded (Fig 1). No antiarrhythmic medications were administered because the heart rate was not excessively rapid and the horse was normotensive. Arterial blood gas analysis revealed adequate perfusion and oxygenation. The heart rate and rhythm were continuously monitored. Attempts to decrease the horse' s reliance on mechanical ventilation were unsuccessful. Results of neurologic evaluation and a brain auditory evoked response test were indicative of quadriparesis, and the horse was euthanatized after additional rhythm strips were obtained (Fig 2 and 3).Postmortem examination did not reveal any cardiac or respiratory abnormalities. However, the soft palate and larynx were diffusely and severely swollen. There was a cervical fracture at C 2 -C 3 , with displacement of the fracture fragments and transection of the cervical spinal cord. The cause of the cervical fracture was not determined; physical injury may have occurred while the horse was disoriented during recovery, or as a result of panic created by obstruction of the upper portion of its respiratory tract. ECG InterpretationThe first ECG rhythm strip obtained (Fig 1) revealed an irregularly irregular rhythm, with mean ventricular rate of 62 beats/min. There were no P waves, but coarse baseline undulations (f waves) were present. These ECG features are characteristic of atrial fibrillation. The T waves changed polarity after the fifth QRS complex, a finding that is neither unusual nor important in horses. 1 The second ECG rhythm strip (Fig 2) was recorded approximately 40 minutes later. During this time, the horse was ventilated mechanically and received supportive treatment, including IV administration of fluids, and doses of dexamethasone sodium phosphate (100 mg, IV) and mannitol (250 g, IV). The R-R intervals became less irregular, and organized atrial activity was present (P' waves). However, the atrial rate was rapid with more P' waves than QRS complexes. In the latter part of the strip, where there was a pause in the ventricular rhythm, the atrial rate was 215 beats/min, indicating that additional P' waves were most likely hidden within the QRS complexes at the beginning of the rhythm strip. This rhythm represented atrial tachycardia with physio...

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Neurocardiology

Natelson¹

1985

Arch Neurol

118

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Cardiac arrhythmias accompanying acute compression of the spinal cord

Cited by 39 publications

References 16 publications

Acute Changes in Systemic Hemodynamics and Serum Vasopressin After Complete Cervical Spinal Cord Injury in Piglets

Acute Changes in Systemic Hemodynamics and Serum Vasopressin After Complete Cervical Spinal Cord Injury in Piglets

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Neurocardiology

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