Focal myocardial necrosis associated with multiple sclerosis of the medulla

      This paper is only available as a PDF. To read, Please Download here.


      A debate exists as to the capacity of the central nervous system to induce vasospasm of resistance vessels in the coronary circulation both in healthy persons and in patients with coronary artery disease. A view exists suggesting that direct central neural stimulatory effects on the coronary arteries are minimal1 and that central nervous system stimulation as occurs in head injury results in a generalized autonomie response with circulating catecholamines arising from the adrenal gland causing toxic damage to the myocardium.2 A contrasting view is that the extensive intrathoracic sympathetic nervous system that directly innervates the coronary arteries when stimulated can induce myocardial ischemia, which, if prolonged, induces myocardial infarction.3 In this report, we describe a young woman with a brief history of multiple sclerosis involving the medulla who presented with myocardial infarction, and subsequently died.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Marcus ML
        Neurol control of the coronary circulation.
        in: Marcus ML The Coronary Circulation in Health and Disease. McGraw-Hill, New York1983: 129-146
        • Norris JW
        Cardiac effects of acute cerebrovascular lesions.
        in: Kulbertus HE Franck G Neurocardiology. Futura Publishing Company, Mount Kisco, NY1988: 211-219
        • Janes RD
        • Brandys JC
        • Hopkins DA
        • Johnstone DE
        • Murphy DA
        • Armour JA
        Anatomy of human extrinsic cardiac nerves and ganglia.
        Am J Cardiol. 1986; 57: 299-309
        • Dampney R
        The subretrofacial nucleus: its pivotal role in cardiovascular regulation.
        News In Physiological Sciences. 1990; 5: 63-67
        • Feigl EO
        Reflex control of the coronary circulation.
        in: Vanhoutte PM Vasodilatation: Vascular Smooth Muscle, Peptides, Autonomic Nerves, and Endothetium. Raven Press, New York1988: 307-310
        • Dobson Jr, JG
        Mechanism of adenosine inhibition of catecholamine-induced responses in heart.
        Circ Res. 1983; 52: 151-160