Role of Stellate ganglion block in post CABG sympathetically mediated chest pain.
Acute chest pain is a common presentation in emergency. After clinical assessment undiagnosed chest pain can become a difficult problem. Sympathetically mediated chest pain is a rare presentation, as it is similar to that of secondary hyperalgesia in the intact skin surrounding an injury site. We are reporting a case of a 62 years old man who presented with atypical chest pain four months after coronary artery bypass grafting (CABG). On investigation no new change was noticed than previous evaluation. On chronic pain assessment he was having hyperalgesia to light touch in addition to the spontaneous chest pain. He was treated as a case of sympathetically mediated chest pain, pain modulators, analgesics and Stellate ganglion block. Patient responded dramatically to Stellate ganglion block and returned to work within two weeks time. This case illustrated the importance of early diagnosis of sympathetically mediated chest pain and role of Stellate ganglion block.
Khan
Mueen Ullah
MU
Department of Anaesthesia and Intensive Care, Aga Khan University, Karachi.
Ahmed
Imtiaz
I
D000208:Acute Disease; D000588:Amines / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002637:Chest Pain / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009407:Nerve Block; D013233:Stellate Ganglion; D013564:Sympathetic Nervous System / Q000187:drug effects*; D013997:Time Factors; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000929:Antidepressive Agents, Tricyclic; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D009020:Morphine