[Sandel]

Are Cardiac Syndrome X, Irritable Bowel Syndrome and Reflex Sympathetic Dystrophy Examples of Lateral Medullary Ischaemic Syndromes?

"Altered pain appreciation and autonomic function are hallmarks of Cardiac syndrome X, Irritable bowel syndrome and Reflex sympathetic dystrophy. Both pain appreciation and autonomic function are controlled by the lateral medulla. This hypothesis proposes that lateral medullary ischaemia at a microvascular level is responsible for these syndromes and could also be linked to other conditions where autonomic dysfunction is a major feature such as late-onset asthma, type 2 diabetes and essential hypertension. Autonomic function is controlled by the nucleus tractus solitarius, which acts as the main viscero-afferent nucleus in the brain stem regulating vagal tone. It is particularly susceptible to ischaemia since it is highly metabolically active and lies in a medullary arterial watershed zone. The anatomical route of the vertebral artery through cervical vertebra makes it vulnerable to injury from whiplash with or without any genetic predisposition to atheroma formation. This could make microvascular occlusion commonplace and a plausible explanation for the above syndromes. Ischaemia rather than infarction occurs because of the excellent collateral blood supply in the brainstem. In support of this hypothesis, a new Transcranial doppler ultrasonography arterial signal has been described called small vessel knock, the ultrasound signal of small vessel occlusion. Recent evidence has shown that ultrasound targeting of this signal in the vertebral artery improves clinical symptoms in these syndromes which supports this hypothesis. Two such cases are discussed."

http://www.level1diet.com/11077_id
http://www.ncbi.nlm.nih.gov/sites/en...arch&db=pubmed

[Imahotep]

This is fascinating stuff and even seems consistent with my experience but it's still a little difficult to believe. This damage would already have to be present and, presumably, dormant when the exciting event occurred. I got a head injury not too long after the RSD and had a car accident two decades earlier.

Certainly there is a "different appreciation" for the pain involved.

[Sandel]

I have done a fair search into this cardiac syndrome X and it describes the chest pain and test results of RSD of the heart!
Tests results such as ichemic areas showing up on a chemical heart stress test (MIBI), yeat no blockages of the arterys showing up on an angiogram, and abnormal ST levels on ECG's. I think this CSX is infact RSD of the heart and I think the hypothesis proposed makes alot of sence.

This hypothesis proposes that lateral medullary ischaemia at a microvascular level is responsible for these syndromes and could also be linked to other conditions where autonomic dysfunction is a major feature such as late-onset asthma, type 2 diabetes and essential hypertension. Autonomic function is controlled by the nucleus tractus solitarius, which acts as the main viscero-afferent nucleus in the brain stem regulating vagal tone. It is particularly susceptible to ischaemia since it is highly metabolically active and lies in a medullary arterial watershed zone.

Irritable bowel syndrome, same thing diffrent area.. also endemetreosis (sp?) all caused I think by microvascular ischemia, RSD same thing, I believe it starts with the swelling of the injured area doing the damage to cells and to the small nerve fibers ect ect..

[Sandel]

Originally Posted by Imahotep

This is fascinating stuff and even seems consistent with my experience but it's still a little difficult to believe. This damage would already have to be present and, presumably, dormant when the exciting event occurred. I got a head injury not too long after the RSD and had a car accident two decades earlier.

Certainly there is a "different appreciation" for the pain involved.

Hi Imahotep,
Well we certainly know that we react diffrently to pain and injury now, but I have had an exagerated pain response before I got RSD (never for long though) and that makes me think its quite possible you are be right about ischemic damage being present before RSD injury.

It seems very probibable that damage causing microvascular ischemia can build up over time with our injurys, but I tend to think it needs an inciting event at some point to start the whole dysfunctional process going.
Time to re-read Vics posts on IRI and to research more into this.. to find the cause will go along way towards finding a cure in my thinking, and more and more I see the research leading in this direction.

[dreambeliever128]

I am dealing with what sounds like the Cardiac Syndrome X and have been since I got RSD.

I had one angiogram that showed minimal blockage. The same Dr. went in again a couple years later and found no blockage at all and that puzzled him. Monday I am going to a new heart Dr. to go through this again. My Dr. definately thinks I have some heart problems now due to inheritance and the other problems I'm having so he's making me go through all of this again.

I am going in again today for shots in my chest area. Some calm down, some don't. So it is possible that it builds up over time with RSD.

From what I have read about the IRI and the RSD it is heading toward connecting them together.

Thanks so much for this.

Ada

[dreambeliever128]

I just wanted to correct what I said. My Dr. told me today that the first angiogram I had showed nothing but the second showed a blockage. I could have sworn it was the other way around but then that's my brain at work. Can you have RSD of the brain?

While I was in there today they did an electrocardigram on me and he said it looked ok but I see the heart Dr. Monday so we will know more after that.

I do think IRI and RSD do have something in common. I did talk to him about this and he said he'd read up on it and give me his opinion.

Ada