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Cardiovascular Function After SCI

by Rushton,Jeff last modified Oct 21, 2011 04:01 PM

In addition to the loss of motor and sensory functioning, spinal cord injury (SCI), depending on the neurological level, may sever the descending sympathetic pathways that function in the control of the heart and arterial resistance within vessels, compromising blood pressure regulation [3;11-13;21]. On a daily basis, individuals with SCI face the challenge of managing their unstable blood pressure, which frequently results in persistent hypotension and/or episodes of uncontrolled hypertension[9;11;12;16;21]. Moreover, cardiovascular disorders in the acute and chronic stages of SCI are among the most common causes of death in individuals with SCI [6;12;17]. The lost of mobility and reduced activity levels accompanied by SCI contribute this increasing risk [7;12;18]. These cardiovascular conditions severely delay an individual’s participation in rehabilitation, extend hospital stay, limit the effectiveness of other treatments and interfere with daily life activities.

Low resting arterial blood pressure and orthostatic hypotension are common clinical problems in both acute and chronic SCI [2;4;8;12;14;15;21]. These conditions are thought to be related to the pooling of blood following increased plasma filtration in dependent regions of the body during upright posture leading to decreased venous return and reduced blood pressure[13;21]. Decreased or diminished sympathetic activity, the loss of lower extremity muscle function, impaired pulmonary function, increased venous compliance, decreased vascular dilation and impaired baroreflex regulation play major roles in these conditions after SCI [1;5;11;20;21]. Baseline low arterial blood pressure is commonly associated with increased fatigue, difficulties with concentration, and an inability to participate in activities of daily life. Symptoms related to orthostatic hypotension include fatigue or weakness, light-headedness, dizziness, blurred vision, dyspnea and restlessness [5;10;19].

Reference List

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