Cervical Angina caused by Unstable Cervical Spondylotic Myelopathy: A Case Report

Abstract

Cervical angina is defined as anterior chest pain that resembles true cardiac angina but originates from cervical spondylosis. This symptom commonly results from compression of a nerve root. We present a case of cervical angina caused by unstable cervical spondylotic myelopathy. A 72-year-old woman presented with a complaint of anterior chest pain. After excluding coronary artery disease, C3-7 expansive open-door laminoplasty with C3-4 transarticular screw fixation was performed. After surgery the chest pain improved. Therefore we diagnosed this case as cervical angina caused by spinal cord compression at C3-7 level. We presumed that the main mechanism of this symptom was as follows: 1. deactivation of the descending pain inhibitory pathway in the posterior horn of the C3-7 spinal cord 2. referred pain caused by unstable facet joint and anterior or posterior longitudinal ligament of the cervical spine. Cervical angina caused by cervical myelopathy should be included in the differential diagnosis of anterior chest pain. We mention the etiology and clinical characteristics of cervical angina.