Cardiac arrest attributable to dysfunction of the autonomic nervous system after traumatic cervical spinal cord injury.
Bradycardia is the most common form of dysrhythmia developing after disruption of the sympathetic pathway by a spinal cord injury (SCI), and it can have fatal consequences, including cardiac arrest. Here, we report a case of cardiac arrest developing after cervical SCI attributable to sympathetic hypoactivity. A 26-year-old male pedestrian was admitted after a traffic accident. Radiologically, fractures were apparent at the C6-7bilateral articular facets, and cord contusion with hemorrhage was evident at C4-7. During his stay in ICU, intermittent bradycardia was noted, but the symptoms were not specific. On the 22nd postoperative day, the patient was taken to the computed tomography suite for further evaluation and experienced cardiac arrest during a positional change. After immediate cardiac massage, the patient was resuscitated. We scheduled Holter monitoring, which detected 26 pauses, the longest of which was 17.9 s. The patient underwent cardiac pacemaker insertion. No further cardiac events were noted.
Division of Pulmonary, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sei Won
SW
Kim
Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
Chan Joo
CJ
Park
Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
Kyungil
K
Kim
Department of Orthopaedic Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea. Electronic address: cruzinbooo@naver.com.
Yoon-Chung
YC
Kim
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D006323:Heart Arrest / Q000209:etiology*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D013119:Spinal Cord Injuries / Q000150:complications*; D014057:Tomography, X-Ray Computed
Heart arrest; Parasympathetic nervous system; Spinal cord injuries; Sympathetic nervous system