Topical Organization of the Cardiac Sympathetic Nervous System

Thomas, Jane deLima; Gerdisch, Marc W.

doi:10.1007/978-3-662-11038-6_1

Cited by 3 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The posterobasal wall of the left ventricle is mainly supplied by the left‐sided sympathetic system by the fibers traveling across the left circumflex artery, while the antero‐apical wall of the left ventricle is predominantly innervated by the fibers from the right‐sided sympathetic system traveling alongside the left anterior descending artery 15 . Schlack et al 16 .…”

Section: Discussionmentioning

confidence: 99%

An Unusual Complication of Sinus Arrest Following Right‐Sided Stellate Ganglion Block: A Case Report

Saxena¹,

Saxena

Aggarwal

et al. 2004

Pain Practice

View full text Add to dashboard Cite

We present a case of a 29-year-old female patient who had presented to us for the management of her chronic right shoulder-hand pain and developed a sinus arrest following a right-sided stellate ganglion block (RSGB). This patient on receiving a diagnostic RSGB via the anterior paratracheal (C6) approach developed sinus arrest followed by apnea and unconsciousness. On institution of resuscitative measures involving tracheal intubation, positive pressure ventilation, cardiac massage, and intravenous atropine, spontaneous cardiac activity recovered in about 3 minutes. Other signs and symptoms resolved fully in a total of 10 minutes. She had persistent postural hypotension lasting for about 24 hours requiring bed rest and was discharged about 36 hours after the procedure, without any adverse sequelae. As the sinus node is supplied by the right-sided sympathetic chain, its blockade probably resulted in unopposed parasympathetic activity leading to asystole. Available evidence of the role of right stellate ganglion in regulation of cardiac electrophysiology and functioning is also discussed.

show abstract

Section: Discussionmentioning

confidence: 99%

An Unusual Complication of Sinus Arrest Following Right‐Sided Stellate Ganglion Block: A Case Report

Saxena¹,

Saxena

Aggarwal

et al. 2004

Pain Practice

View full text Add to dashboard Cite

show abstract

“…Left sided SGB is also effective in treating the prolonged QT‐syndrome [15], an electrophysiological disorder. Besides having these therapeutic effects, SGB will also concomitantly result in sympathetic denervation of a part of the ventricular wall because different left ventricular regions are supplied by the left or right sympathetic system [16]. At the same time, other parts of the ventricle stay under the normal or even compensatory increased influence of the unblocked side.…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic effects of a left stellate ganglion block in ASA I patients. An echocardiographic study

Schlack

Dinter

2000

Eur J Anaesthesiol

View full text Add to dashboard Cite

In anaesthetized dogs, stellate ganglion blockade led to a moderate disturbance in left ventricular diastolic function. We investigated the effect of a left-sided block, following injection of 10 mL bupivacaine 0.5%, on echocardiographic variables of ventricular function in eight otherwise healthy patients with sympathetically mediated pain syndromes. After the blockade, heart rate (control: 66+/-3 (mean+/- SEM), block: 64+/-3 min-1) and mean arterial blood pressure (88.5+/-6.0 vs. 84.0+/-8.1 mmHg) were unchanged, but afterload decreased (end-systolic meridional wall stress; 69.6+/-9.9 vs. 59.8+/-7.1, P < 0.05). Stroke volume increased from 71.2+/-8.1 to 79.6+/-7.4 mL, P < 0.05. Variables of systolic function were unchanged, but relaxation was prolonged (isovolumic relaxation time; 71+/-5 vs. 81+/-4 ms, P < 0.05). In patients who were ASA I, there was a small impairment in echocardiographic variables during ventricular relaxation after a left stellate ganglion blockade. This small effect did not compromise ventricular function, and the heart responded with a small stroke volume increase to the simultaneous afterload reduction.

show abstract