Cardiac dysfunctions following spinal cord injury

Cardiac dysfunctions are common complications following spinal cord injury (SCI). Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of SCI. SCI causes disruption of descendent pathways from central control centers to spinal sympathetic neurons, originating into intermediolateral nuclei of T1-L2 spinal cord segments. Loss of supraspinal control over sympathetic nervous system results in reduced overall sympathetic activity below the level of injury and unopposed parasympathetic outflow through intact vagal nerve. Impairment of autonomic nervous control system, mostly in patients with cervical or high thoracic SCI, causes cardiac dysrrhythmias, especially bradycardia and, rarely, cardiac arrest, or tachyarrhytmias and hypotension.

• 1
  SCI associates significant cardiac dysfunction, particularly in patients with cervical or high thoracic injuries, leading to arrhythmias like bradycardia and hypotension.
• 2
  Spinal shock, occurring acutely, involves bradycardia and hypotension, while autonomic dysreflexia, a chronic phase issue, presents as life-threatening hypertension with compensatory bradycardia.
• 3
  Additional cardiac complications such as cardiac deconditioning and coronary heart disease may also occur in SCI patients.