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Case report
peer-reviewed

Cardiovascular Dysfunction Presenting as Autonomic Dysreflexia in a Patient with Spinal Cord Injury



Abstract

Autonomic dysreflexia (AD) is a medical emergency that is characterized by hypertension as an autonomic response to noxious stimuli in patients with a history of spinal cord injury at the level of T6 or above. We present the case of a 31-year-old Caucasian male with a history of spinal cord injury at the level of C3-C4, with symptoms described as recurring episodes of hypertension with flushing and sweating above the level of the lesion for the past five to six years. His symptoms are triggered by bowel distention, excitement, a bumpy car ride, or a simple turning of the neck to the left. Physical examination and laboratory studies ruled out other possible differentials (e.g., migraines, pheochromocytoma). As a result, AD was diagnosed.



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Case report
peer-reviewed

Cardiovascular Dysfunction Presenting as Autonomic Dysreflexia in a Patient with Spinal Cord Injury


Author Information

Ahmed H. Qavi Corresponding Author

Department of Medicine, Mahroof Hospital

Salman Assad

Department of Medicine, Shifa International Hospital, Islamabad, Pakistan

Wardha Shabbir

MD, Windsor University Medical School

Maryam Kundi

Pain Management, Institute of Advanced Medicine and Surgery, Philadelphia, Pa

Maham Habib

Department of Internal Medicine, Carthage Area Hospital, New York, USA

Sumbal Babar

Department of Internal Medicine, Carthage Area Hospital, New York, USA

Mehr Zahid

Internal Medicine, University of Lahore, Lahore, Pakistan


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent was obtained from the patient prior to submitting this article for publication. No patient identifying information appears in the article text or images. . Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Cardiovascular Dysfunction Presenting as Autonomic Dysreflexia in a Patient with Spinal Cord Injury


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Case report
peer-reviewed

Cardiovascular Dysfunction Presenting as Autonomic Dysreflexia in a Patient with Spinal Cord Injury

  • Author Information
    Ahmed H. Qavi Corresponding Author

    Department of Medicine, Mahroof Hospital

    Salman Assad

    Department of Medicine, Shifa International Hospital, Islamabad, Pakistan

    Wardha Shabbir

    MD, Windsor University Medical School

    Maryam Kundi

    Pain Management, Institute of Advanced Medicine and Surgery, Philadelphia, Pa

    Maham Habib

    Department of Internal Medicine, Carthage Area Hospital, New York, USA

    Sumbal Babar

    Department of Internal Medicine, Carthage Area Hospital, New York, USA

    Mehr Zahid

    Internal Medicine, University of Lahore, Lahore, Pakistan


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent was obtained from the patient prior to submitting this article for publication. No patient identifying information appears in the article text or images. . Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: July 10, 2017

    DOI

    10.7759/cureus.1456

    Cite this article as:

    Qavi A H, Assad S, Shabbir W, et al. (July 10, 2017) Cardiovascular Dysfunction Presenting as Autonomic Dysreflexia in a Patient with Spinal Cord Injury. Cureus 9(7): e1456. doi:10.7759/cureus.1456

    Publication history

    Received by Cureus: June 19, 2017
    Peer review began: June 23, 2017
    Peer review concluded: June 27, 2017
    Published: July 10, 2017

    Copyright

    © Copyright 2017
    Qavi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Autonomic dysreflexia (AD) is a medical emergency that is characterized by hypertension as an autonomic response to noxious stimuli in patients with a history of spinal cord injury at the level of T6 or above. We present the case of a 31-year-old Caucasian male with a history of spinal cord injury at the level of C3-C4, with symptoms described as recurring episodes of hypertension with flushing and sweating above the level of the lesion for the past five to six years. His symptoms are triggered by bowel distention, excitement, a bumpy car ride, or a simple turning of the neck to the left. Physical examination and laboratory studies ruled out other possible differentials (e.g., migraines, pheochromocytoma). As a result, AD was diagnosed.



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Ahmed H. Qavi, M.D.

Department of Medicine, Mahroof Hospital

For correspondence:
aqavi@montefiore.org

Salman Assad, M.D.

Department of Medicine, Shifa International Hospital, Islamabad, Pakistan

Wardha Shabbir

MD, Windsor University Medical School

Maryam Kundi, M.D.

Pain Management, Institute of Advanced Medicine and Surgery, Philadelphia, Pa

Maham Habib

Department of Internal Medicine, Carthage Area Hospital, New York, USA

Sumbal Babar, M.D.

Department of Internal Medicine, Carthage Area Hospital, New York, USA

Mehr Zahid

Internal Medicine, University of Lahore, Lahore, Pakistan

Ahmed H. Qavi, M.D.

Department of Medicine, Mahroof Hospital

For correspondence:
aqavi@montefiore.org

Salman Assad, M.D.

Department of Medicine, Shifa International Hospital, Islamabad, Pakistan

Wardha Shabbir

MD, Windsor University Medical School

Maryam Kundi, M.D.

Pain Management, Institute of Advanced Medicine and Surgery, Philadelphia, Pa

Maham Habib

Department of Internal Medicine, Carthage Area Hospital, New York, USA

Sumbal Babar, M.D.

Department of Internal Medicine, Carthage Area Hospital, New York, USA

Mehr Zahid

Internal Medicine, University of Lahore, Lahore, Pakistan