Clin Exp Emerg Med.  2017 Jun;4(2):109-112. 10.15441/ceem.16.121.

Spinal cord infarction mimicking ischemic heart disease

• Lee DW
• Choi YH

• KMID: 2385938
• DOI: http://doi.org/10.15441/ceem.16.121

Abstract

Spinal cord infarction is a rare condition and is easily misdiagnosed owing to its initial non-specific manifestation. We report a case of a 77-year-old man who presented with chest pain and upper back pain initially, and was misdiagnosed with a myocardial infarction. Four hours after admission, he complained of numbness in his entire left leg below the knee, with rapid deterioration of neurological symptoms. After 9 hours, loss of sensation progressed up to the T4 dermatome, strength of both lower extremities deteriorated to grade 0, and decrease in anal tone and deep tendon reflex was observed. Initial magnetic resonance imaging findings were normal; however, a signal change occurred 3 days after symptom onset. When patients present with acute chest pain and neurologic symptoms, the possibility of ischemic cardiac disease as well as any neurological manifestations must be investigated. Emergency physicians must remember the value of serial physical examinations.

Keyword

Spinal cord ischemia; Chest pain; Back pain

MeSH Terms

Back Pain
Chest Pain
Emergencies
Heart Diseases
Humans
Hypesthesia
Infarction*
Knee
Leg
Lower Extremity
Magnetic Resonance Imaging
Myocardial Infarction
Myocardial Ischemia*
Neurologic Manifestations
Physical Examination
Reflex, Stretch
Sensation
Spinal Cord Ischemia
Spinal Cord*