title: Haemodynamic collapse in a patient with acute inferior myocardial infarction and concomitant traumatic acute spinal cord injury.
abstract: A 71-year-old man suddenly collapsed and went into cardiopulmonary arrest. The cardiopulmonary resuscitation attempt succeeded in restoration of spontaneous circulation. The initial 12-lead electrocardiogram showed inferior acute myocardial infarction (AMI). The patient was initially diagnosed as having cardiogenic shock associated with inferior AMI. In spite of early coronary revascularisation, bradycardia and hypotension were sustained. After termination of sedation and extubation, he was found to have a quadriplegia and diagnosed with a cervical spinal cord injury (SCI). Therefore, the patient was finally diagnosed with neurogenic shock caused by acute cervical SCI due to the traumatic injury preceded by loss of consciousness complicating inferior AMI. We should recognise that SCI has unique haemodynamic features that mimic those associated with inferior AMI, but requires very different treatment.
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Kumagai
authors.forename: Kaoru
authors.initials: K
authors.lastname: Dohi
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanigawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation; D002574:Cervical Vertebrae / Q000473:pathology*; D003937:Diagnosis, Differential; D006323:Heart Arrest / Q000209:etiology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D062645:Percutaneous Coronary Intervention; D011782:Quadriplegia / Q000209:etiology; D012770:Shock, Cardiogenic / Q000175:diagnosis* / Q000209:etiology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D055009:Spondylosis / Q000175:diagnosis*