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Complex Regional Pain Syndrome Type I After Myocardial Infarction Treated With Spinal Cord Stimulation
  1. Shihab U. Ahmed, M.B., B.S., M.P.H.
  1. From the Massachusetts General Hospital Pain Center, Department of Anesthesia and Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
  1. Reprint requests: Shihab U. Ahmed, M.B., B.S., M.P.H., MGH Pain Center, WACC 324, 15 Parkman St, Boston, MA 02114. E-mail: sahmed{at}partners.org

Abstract

Objective A rare case of Complex Regional Pain Syndrome (CRPS) type I after myocardial infarction (MI) and significant comorbid illness with few treatment options for pain control was successfully managed with the placement of a spinal cord stimulator (SCS).

Case Report A 44-year old man presented with left upper extremity burning pain after MI. His past medical history included insulin-dependent diabetes mellitus, oxygen-dependent idiopathic pulmonary fibrosis, and recent coronary revascularization surgery. His pain was presumed to be related to his MI and a clinical diagnosis of CRPS type I (or reflex sympathetic dystrophy) was made. Facing limited medical and less invasive options for his pain relief, he underwent a spinal cord stimulation trial with excellent response. He had more than 70% pain relief from the spinal cord stimulation at the last follow-up, 2 years later.

Conclusion CRPS type I after MI can be difficult to treat because of other comorbid illnesses. SCS can be a safe and effective mode of therapy for patients facing limited treatment options.

  • Myocardial infarction
  • Complex regional pain syndrome
  • Spinal cord stimulator

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