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Neurology (Expert Forum)
heart and hearniated Thoracic 34 disc
Answered by
Cleveland - OH
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heart and hearniated Thoracic 34 disc
by pete9, Feb 16, 2008 10:00AM
hi i am a 42 year old male with herniated disc at t3/4 and t 9/10 both deforming spinal cord 4mm,,i have had previous mi due to blockages ,fixed with stents,,in the past 14 months i have had 5 more mi ,,had angio and no significant blockages to cause this,,,i am wondering if discs could possibly be the culprit,,maybe compressing heart nerve??also have thoracic outlet syndrom and occasional absense seisures after days of exessive arm usage above around 9th rib level ie driving or like bending picking weeds ect///any ideas?? much appreciated..peter
Doctor's Answer
by Joyce K Lee, MD, Mar 10, 2008 11:23AM
, Mar 10, 2008 11:23AM
To: Peter
Dear Peter,
Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer an absolutely precise diagnosis based on your history and list of symptoms.I am limited in not having the opportunity to perform a full neurologic examination on you, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.
With regard to the two herniated thoracic discs - were these seen on a thoracic MRI ? if so, does the report note any so-called signal changes within the spinal cord to suggest that there is frank spinal cord compression ?. Along the same lines, one would also need to know whether you have experienced any leg weakness, falls, unsteadiness, decreased sensation in the legs or trunk, and loss of bowel and bladder function such as urinary incontinence. If present, these may be signs of spinal cord compression.
The question of whether or not these MRI findings are related to a number of recent cardiac events you have experienced is a somewhat more difficult one. The first thing that needs to be sorted out is "What is the cause of your chest pain- cardiac or noncardiac ?. One way to answer this question is to determine whether or not there are indeed "blockages" present in the coronary arteries, as you had suggested. A myocarcial infarction diagnosed by ECG/ lab studies may reveals one or more of these "blockages" after a test called an angiogram. Furthermore, I am not aware of a any medical literature with evidence of a thoracic disc herniation presenting with, or causing, a myocardial infarction - there is one published report of a thoracic disc herniation presenting with nausea and abdominal pain. In general, upper thoracic disc herniation may manifest as neck pain and lower thoracic discs may present as lumbar back pain. However, the disc pain may also be "referred" to the abdomen, sternum, and groin areas, potentially resulting in a misdiagnoses such as cholecystitis, myocardial infarction, hernia, or nephrolithiasis. That being said, I am in no way suggesting that you were "misdiagnosed". In other words, it is very unlikely that a cardiologist would place a stent (or stents as in your case) simply because you have had chest pain - there would need to be a narrowing identified in one of the coronary arteries before they would get to that stage of treatment.
One thing does seem very clear however. At the age of 42, you seem to have already had a large number of cardiac insults that are, and can continue to be, very serious (and even-life threatening). As you stated you have had prior stents placed, so it is likely you have already seen a cardiologist. At this point, I would recommend a very close follow up with your cardiologists.
Finally, I am not aware of any relationship between thoracic outlet syndrome and abscence seizures.
Best wishes,
JKL,MD
Thank you for submitting your question.
I will answer your concerns to the best of my abilities, but please be informed that I am unable to offer an absolutely precise diagnosis based on your history and list of symptoms.I am limited in not having the opportunity to perform a full neurologic examination on you, nor am I able to review the pertinent imaging.
This is solely for educational purposes and should in no way be a substitute for a formal evaluation by a certified physician.
With regard to the two herniated thoracic discs - were these seen on a thoracic MRI ? if so, does the report note any so-called signal changes within the spinal cord to suggest that there is frank spinal cord compression ?. Along the same lines, one would also need to know whether you have experienced any leg weakness, falls, unsteadiness, decreased sensation in the legs or trunk, and loss of bowel and bladder function such as urinary incontinence. If present, these may be signs of spinal cord compression.
The question of whether or not these MRI findings are related to a number of recent cardiac events you have experienced is a somewhat more difficult one. The first thing that needs to be sorted out is "What is the cause of your chest pain- cardiac or noncardiac ?. One way to answer this question is to determine whether or not there are indeed "blockages" present in the coronary arteries, as you had suggested. A myocarcial infarction diagnosed by ECG/ lab studies may reveals one or more of these "blockages" after a test called an angiogram. Furthermore, I am not aware of a any medical literature with evidence of a thoracic disc herniation presenting with, or causing, a myocardial infarction - there is one published report of a thoracic disc herniation presenting with nausea and abdominal pain. In general, upper thoracic disc herniation may manifest as neck pain and lower thoracic discs may present as lumbar back pain. However, the disc pain may also be "referred" to the abdomen, sternum, and groin areas, potentially resulting in a misdiagnoses such as cholecystitis, myocardial infarction, hernia, or nephrolithiasis. That being said, I am in no way suggesting that you were "misdiagnosed". In other words, it is very unlikely that a cardiologist would place a stent (or stents as in your case) simply because you have had chest pain - there would need to be a narrowing identified in one of the coronary arteries before they would get to that stage of treatment.
One thing does seem very clear however. At the age of 42, you seem to have already had a large number of cardiac insults that are, and can continue to be, very serious (and even-life threatening). As you stated you have had prior stents placed, so it is likely you have already seen a cardiologist. At this point, I would recommend a very close follow up with your cardiologists.
Finally, I am not aware of any relationship between thoracic outlet syndrome and abscence seizures.
Best wishes,
JKL,MD