Background & Aims
“Cervical Angina is defined as pseudo angina that resembles true cardiac angina but it actually originates from cervical spine pathologies along with cervical nerve root compression.” This condition most commonly originates from or results from compression of C7 nerve root. Though involvement of other nerve roots cannot be denied, quite a few number of people approaching Orthopaedician having severe symptoms might have to undergo surgery and they do get benefits from surgery too. But our class of patients get relief from cervical angina without any surgery, by multimodal pain management.
The objective of this study is to assess prevalence of cervical angina i.e. chest pain (atypical/ non cardiac) as important presentation of cervical spine pathologies amongst number of patients with chest pain presentation as chief complaint along with tingling, numbness and neck pain.
Methods
Retrospective collection of data from patients visiting Pain OPD with complaints of neck pain, chest pain and tingling numbness along the upper extremity was done. At times patients also complained of headache along with above symptoms. Red flags ruled out. This data was collected from duration of January 2018 to December 2023, having total of 346 patients. Those having Chronic atypical (non cardiac)chest pain were analyzed and treated with Pharmacotherapy, Intramuscular stimulation and cervical epidural adhesiolysis depending on symptoms, their severity and cervical pathology as diagnosed on radiological investigations like X ray and MRI.
Results
Among total of 346 patients related to cervical spine pathologies 37 patients had reported chronic chest pain as one of the symptom. Out of 37 patients 25 [67%] patients presented with chest pain as presenting symptom and 12 [33%] as associated chest pain. All 37 patients had cervical radiculopathy with or without nerve compression. 18 [49%] treated with pharmacotherapy and physiotherapy,10 [27%] were treated with IMS and pharmacotherapy and 9 [24%] underwent cervical epidural adhesiolysis where conservative management failed. No one of them required surgical intervention.
Conclusions
Though Chest pain is a very common presenting with different etiologies like Cardiac, Gastrointestinal, myofascial pain, cervical spine pathologies, costochondritis and fibromyalgia. Pain physicians and spine surgeons should have high index of suspicion for cervical spine pathologies in such cases. The possibility of cervical angina should be considered especially when neurological signs and symptoms are also present. Raising this awareness of unusual radiating pattern for cervical pathology will be really useful and definite diagnostic modality for recognition of cervical angina. Of all cervical spine pathologies disc bulges remain in the uppermost reason for the cause of cervical angina.
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Presenting Author
Varsha Kurhade
Poster Authors
Varsha Kurhade
MD
K K Care Hospital
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Neck Pain