{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:46:33Z","timestamp":1772109993227,"version":"3.50.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Spinal cord injury (SCI) is a significant cause of morbidity and mortality with an incidence of 40\u201383\/million\/year. Sympathetic denervation in SCI leads to cardiovascular abnormalities including orthostatic hypotension, rhythm disturbance, and repolarization changes. Electrocardiographic (ECG) findings include bradyarrhythmias, ectopic beats, long QT interval, and ST-T changes that may be mistaken for myocardial ischaemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A patient in their 40\u2005s with free past medical history was referred to our centre with the diagnosis of non-ST elevation acute coronary syndrome. On presentation, chest pain was diffuse and radiating to the back. Twelve-lead ECG showed deep symmetrical T-wave inversion. Echocardiography and cardiac troponin were normal. The patient was scheduled for multi-slice computed tomography coronary angiography which was normal; however, a few hours after admission, the patient developed rapidly progressive motor weakness in both lower limbs with urine retention. Examination revealed motor power Grade 1 in both lower limbs. All sensations were diminished with a sensory level at T6. Urgent magnetic resonance imaging spine revealed neoplastic infiltration of the whole vertebrae with D5\/D6 fracture exerting spinal cord compression. The patient was referred for urgent decompression surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Electrocardiographic changes could be the earliest sign for ongoing SCI. ST-elevation is reported in higher levels of complete injury, while ST depression and inverted T waves can occur independent of lesion level or severity. Misinterpretation of these changes may cause a delay in reaching the correct diagnosis. We highlight the importance of considering neurological causes for ischaemic-like ECG changes, as early recognition could prevent irreversible functional loss.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytad359","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T11:16:21Z","timestamp":1690542981000},"source":"Crossref","is-referenced-by-count":1,"title":["Unusual presentation of acute spinal cord injury with ischaemic electrocardiographic changes: a case report"],"prefix":"10.1093","volume":"7","author":[{"given":"Hossameldin","family":"Hussein","sequence":"first","affiliation":[{"name":"Department of Cardiology, Kasr Al-Ainy Medical School, Cairo University , Cairo , Egypt"},{"name":"Department of Adult Cardiology, Aswan Heart Center , Kasr-El Hagar Street, Aswan 81511 , Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1396-4071","authenticated-orcid":false,"given":"Wessam","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, Aswan Heart Center , Kasr-El Hagar Street, Aswan 81511 , Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"2023081210351448800_ytad359-B1","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-46293-6_1","article-title":"Epidemiology of spinal cord injury","volume-title":"Neurological Aspects of Spinal Cord Injury","author":"Thietje"},{"key":"2023081210351448800_ytad359-B2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1080\/10790268.2002.11753599","article-title":"Early repolarization in patients with spinal cord injury: prevalence and clinical significance","volume":"25","author":"Marcus","year":"2002","journal-title":"J Spinal Cord Med"},{"key":"2023081210351448800_ytad359-B3","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/0002-9149(89)90015-5","article-title":"Altered ventricular repolarization in central sympathetic dysfunction associated with spinal cord injury","volume":"63","author":"Lehmann","year":"1989","journal-title":"Am J Cardiol"},{"key":"2023081210351448800_ytad359-B4","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.hrthm.2011.01.034","article-title":"The correlation between ventricular repolarization and clinical severity of spinal cord injuries","volume":"8","author":"Chung","year":"2011","journal-title":"Heart Rhythm"},{"key":"2023081210351448800_ytad359-B5","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1038\/sc.2016.11","article-title":"Electrocardiographic abnormalities in the early stage following traumatic spinal cord injury","volume":"54","author":"Furlan","year":"2016","journal-title":"Spinal Cord"},{"key":"2023081210351448800_ytad359-B6","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1093\/eurheartj\/ehaa601","article-title":"Questions and answers on antithrombotic therapy and revascularization strategies in non-ST-elevation acute coronary syndrome (NSTE-ACS): a companion document of the 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","volume":"42","author":"Barbato","year":"2021","journal-title":"Eur Heart J"},{"key":"2023081210351448800_ytad359-B7","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S1474-4422(08)70089-9","article-title":"Metastatic epidural spinal cord compression","volume":"7","author":"Cole J","year":"2008","journal-title":"Lancet Neurol"},{"key":"2023081210351448800_ytad359-B8","doi-asserted-by":"crossref","first-page":"189","DOI":"10.4103\/1673-5374.177707","article-title":"Cardiovascular dysfunction following spinal cord injury","volume":"11","author":"Partida","year":"2016","journal-title":"Neural Regen Res"},{"key":"2023081210351448800_ytad359-B9","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S0735-1097(87)80158-4","article-title":"Cardiovascular abnormalities accompanying acute spinal cord injury in humans: incidence, time course and severity","volume":"10","author":"Lehmann","year":"1987","journal-title":"J Am Coll Cardiol"},{"key":"2023081210351448800_ytad359-B10","first-page":"1115-20","article-title":"Cardiovascular complications of spinal cord injury","volume":"132","author":"Hagen","year":"2012","journal-title":"Tidsskrift Nor Legeforen"}],"container-title":["European Heart Journal - 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