Can a Spinal Cord Injury affect my Heart and Circulation?

By Matt Lalande in Spinal Cord Injuries on October 20, 2020

Yes, a spinal cord injury victim can suffer cardiovascular cardiovascular complications following a spinal cord injury.  Cardiac dysfunctions are extremely common complications following SCI. Cardiovascular disturbances are the leading causes of morbidity and mortality in both acute and chronic stages of spinal cord injury.

A Review of Heart Anatomy

The Journal of Spinal Cord Injury Medicine defines your circulatory system  includes your heart, arteries, veins, and capillaries. Your heart is a muscle. It is also an organ. Its purpose is to move blood through your body. The heart speeds up and slows down while pumping, depending on your body’s need for oxygen at any given moment. The circulatory system is designed to send nutrients from absorbed from food in the gastrointestinal tract and oxygen from the lungs to other parts of your body. Because the nervous system helps control the function of your heart and other parts of the circulatory system, its function is often affected after Spinal Cord Injury.

The heart pumps blood to the walls of your lungs where it gathers up oxygen. The blood then returns to the heart and is pumped into the arteries and then to the capillaries, which are tiny blood vessels found throughout your body tissues. Blood flowing through the capillaries delivers oxygen and nutrients to the tissues and gathers waste products from the tissues. The blood flows from the capillaries into the veins, which return the blood to the heart. On the way, the blood gets filtered by the kidneys, which remove wastes by excreting it in the urine. There, the cycle begins again.

Your heart rate is controlled by the two branches of your autonomic nervous system.  The autonomic nervous system is what regulates involuntary movements in your body – such as heart rate, liver function, blood pressure, respiration (your lungs), digestion (your bowels), and sexual arousal.  The two branches of the ANS is the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).  The SNS releases various hormones to speed up your heart, while the PNS releases hormones to slow your heart rate.

Different factors like alcohol, stress exercise or coffee can speed up yoru heart rate temporarily, while relaxing your body and sleep, can slow your heart rate.

Spinal Cord Injury and Cardiovascular Issues

Autonomic Dysfunction – As noted above, your autonomic system controls functions of your body that are “automatic” — such as activities of the bladder, bowel, gastrointestinal tract, liver, heart, and blood vessels.  When a person suffers a spinal cord injury, their autonomic nerves in the spinal cord can be damaged, leading to a myriad of abnormalities in autonomic function – such as the abnormal control of your heart and blood vessels.

Reduced Exercise Capacity – There is also the prevalence of a forced sedentary lifestyle caused by a spinal cord injury.  In his book, “Rehabilitation Medicine Quick Reference – Spinal Cord Injury” author Dr. Bryce notes that the incidence of cardiovascular disease (CVD) rises with duration of SCI and advancing age and is the second leading cause of death in patients with SCI. After living for decades with SCI, CVD becomes the most frequent cause of death. He also notes that cardiovascular disease is the leading cause of death among persons with SCI over 60 years of age (35%). Asymptomatic coronary artery disease (CAD) is most common in persons with complete tetraplegia and least common in those with incomplete paraplegia.

The rate of cardiovascular disease is highly correleated with the level if lesion (spinal cord injury). For example, Dr. Bryce notes that the loss of supraspinal control over the sympathetic nervous system (SNS) after a spinal cord injury above T6 level results in a severly reduced exercise capacity. Also, paralysis of the lower limbs, is statistically associated with profoundly with a sedentary lifestyle.  Reduced exercise capacity and sedentary lifestyle is associated with lipid abnormalities, carbohydrate intolerance, proportionally increased body fat, and obesity, which contribute to arteriosclerosis – and in turn, heart disease.

Spinal cord injury can affect your circulation in two important ways.

First, it can change your blood pressure (the force with which your blood goes to the blood vessels). After an Spinal Cord Injury, some nerves stop sending the messages to keep your arteries tight. As a result, your blood pressure may stabilize at a level that is lower than before the injury. As a result of this change in circulation, orthostatic hypotension (decreased blood pressure which may cause you to become lightheaded when you sit or stand up) might occur. This change can also cause your heart rate to slow, which may cause dizziness or lightheadedness.

Second, a spinal cord injury can change how well blood flows from your body to your heart. The muscles affected by the injury no longer flex and relax as they did before your injury, and the blood does not move throughout your body as well as before. These circulation changes may cause edema (swelling) in your legs and hands, depending on the level of your injury, and blood clots in your legs or lungs. When a blood clot stays in the veins in your leg it’s called a thrombus. Blood clots cause inflammation. Inflammation causes symptoms. If you have the following symptoms in your legs, see your doctor immediately or go to the emergency room:

• Swelling at the site of the clot;
• Gradual onset of pain at the site of the clot (if you can feel pain);
• Redness;
• Warm to the touch’
• Worsening leg pain when bending the foot;
• Leg cramps, especially at night;
• Bluish or whitish discoloration of the skin

Some people have no symptoms when they have a blood clot. This does not make a blood clot any less dangerous.

In some cases, a piece of a blood clot called an embolus might break off and move through the veins up toward the heart and lungs. If a blood clot lodges in one of your lungs (called a pulmonary embolus), it can be deadly. Signs of an embolus in your lungs (a pulmonary embolus include shortness of breath, dizziness, coughing up more phlegm than usual, and coughing up blood. Usually, you are at risk for a blood clot or embolus for a few months immediately after your spinal cord injury. You are also at risk for blood clots beyond that time if you’ve had surgery or if you have been bedridden for a period of time (for example, as caused by a pressure sore, broken bone, etc). If you think you might have a blood clot or an embolus, you should see your doctor immediately because it can be life-threatening.

If you have a spinal cord injury in the low back, you are less likely to have some of the circulatory problems a spinal cord injury can cause. You are less likely to have low blood pressure, a slow heartbeat, or autonomic dysreflexia.  However, if you have a higher spinal cord injury, such as in the upper back or neck, you are more likely to have heart and circulatory issues.

Why is this? Your sympathetic nervous system (SNS) controls the rate at which your heart beats and your blood vessels contract. This is related to your autonomic nervous system (ANS). If your spinal cord is damaged high enough and especially if it is a complete injury, your body’s ability to control your sympathetic nervous system (SNS) is lost.  Studies have shown that circulation in the lower parts of the body is decreased after a spinal cord injury by about fifty to sixty-seven percent of normal since your body can no longer  control the autonomic nervous system (ANS). One study suggests “since there are strong reasons to suspect that this circulation [to the legs] is reduced in these patients [patients with spinal cord injuries in wheelchairs]. Not only is atrophy [wasting away] of the muscles associated with a diminished number of small blood vessels, but patients with spinal cord injuries have increased risk factors for arteriosclerotic changes.” If you can feel your feet, every wonder why they get cold? Now you know. They’re not getting as much blood as they should!

If you’ve suffered a spinal cord injury, we can help. Call us today.

Lalande Personal Injury Lawyers have been practicing spinal cord injury law since 2003. If you’ve suffered an spinal cord injury due to the fault or carelessness of another person, it’s important that you obtain legal advice so that you can determine your best course of actions. You may be entitled to compenstation that can help with  your life long rehab and living requirements. Call us today Nationwide at 1-844-LALANDE or local at 905-333-8888 today, and let our family help yours.

Thank you to the Journal of Spinal Cord Injury Medicine