Abstract
OBJECTIVE--To investigate the possibility that spinal cord stimulation (SCS) used for pain relief can conceal acute myocardial infarction (AMI). DESIGN--Prospective evaluation of patients treated with SCS. SETTING--University hospital. PATIENTS--50 patients with coronary artery disease and severe, otherwise intractable angina treated with SCS for 1-57 months. MAIN OUTCOME MEASURES--Necropsy findings, symptoms, serum enzyme concentrations, electrocardiographic changes. RESULTS--Ten patients were considered to have had AMI. In nine of these SCS did not conceal precordial pain and in one patient no information about precordial pain could be obtained. CONCLUSION--There was no evidence that SCS concealed acute myocardial infarction.
Full text
PDF


Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- APTHORP G. H., CHAMBERLAIN D. A., HAYWARD G. W. THE EFFECTS OF SYMPATHECTOMY ON THE ELECTROCARDIOGRAM AND EFFORT TOLERANCE IN ANGINA PECTORIS. Br Heart J. 1964 Mar;26:218–226. doi: 10.1136/hrt.26.2.218. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Augustinsson L. E. Spinal cord electrical stimulation in severe angina pectoris: surgical technique, intraoperative physiology, complications, and side effects. Pacing Clin Electrophysiol. 1989 Apr;12(4 Pt 2):693–694. doi: 10.1111/j.1540-8159.1989.tb02716.x. [DOI] [PubMed] [Google Scholar]
- Blomberg S., Curelaru I., Emanuelsson H., Herlitz J., Pontén J., Ricksten S. E. Thoracic epidural anaesthesia in patients with unstable angina pectoris. Eur Heart J. 1989 May;10(5):437–444. doi: 10.1093/oxfordjournals.eurheartj.a059507. [DOI] [PubMed] [Google Scholar]
- Dershwitz M., Sherman E. P. Acute myocardial infarction symptoms masked by epidural morphine? J Clin Anesth. 1991 Mar-Apr;3(2):146–148. doi: 10.1016/0952-8180(91)90013-d. [DOI] [PubMed] [Google Scholar]
- Mannheimer C., Augustinsson L. E., Carlsson C. A., Manhem K., Wilhelmsson C. Epidural spinal electrical stimulation in severe angina pectoris. Br Heart J. 1988 Jan;59(1):56–61. doi: 10.1136/hrt.59.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Margolis J. R., Kannel W. S., Feinleib M., Dawber T. R., McNamara P. M. Clinical features of unrecognized myocardial infarction--silent and symptomatic. Eighteen year follow-up: the Framingham study. Am J Cardiol. 1973 Jul;32(1):1–7. doi: 10.1016/s0002-9149(73)80079-7. [DOI] [PubMed] [Google Scholar]
- Marx J. L. Analgesia: how the body inhibits pain perception. Science. 1977 Feb 4;195(4277):471–473. doi: 10.1126/science.195.4277.471. [DOI] [PubMed] [Google Scholar]
- Murphy D. F., Giles K. E. Dorsal column stimulation for pain relief from intractable angina pectoris. Pain. 1987 Mar;28(3):365–368. doi: 10.1016/0304-3959(87)90070-4. [DOI] [PubMed] [Google Scholar]
- Sullivan W., Vlodaver Z., Tuna N., Long L., Edwards J. E. Correlation of electrocardiographic and pathologic findings in healed myocardial infarction. Am J Cardiol. 1978 Nov;42(5):724–732. doi: 10.1016/0002-9149(78)90090-5. [DOI] [PubMed] [Google Scholar]