Severe coronary artery disease presenting with a chief complaint of cervical pain.

Abstract

We present the case of a 49-yr-old man with cervical pain of 14 wk of duration. Physical examination and magnetic resonance imaging of the cervical spine demonstrated no neurologic abnormality or corroborative pathology. Cardiac catheterization demonstrated advanced multivessel disease. The patient underwent successful coronary bypass grafting and was symptom free 12 mo later. Spine practitioners are often consulted by the medical community to determine if a patient's limb or chest complaints might be caused by a spinal pain generator. This atypical case reminds us of the overlap between cardiac and cervical symptom referral. A patient with critical cardiac ischemia can present with predominant cervical complaints.