Chest Tightness and Cough After Cervical Spine Injury

Chest tightness and cough after cervical spine injury?

Hello, doctor.
Thank you for helping me with my concerns.
I was in a car accident two and a half months ago, and after X-ray and MRI examinations, a neurosurgeon diagnosed me with a C5-C6 disc herniation.
I am currently wearing a cervical collar for observation.
I only took medication during the first week and have not taken any Western medicine since.
Besides the neurological symptoms in my limbs, I have some other issues:
1.
Three weeks after the accident, I suddenly lost my voice within two days (diagnosed by an ENT specialist) due to incomplete closure of the vocal cords, laryngitis, and sinusitis.
Aside from the inflammation, there were no other cold symptoms.
Anti-inflammatory medications did not help, so I switched to traditional Chinese medicine.
Although my voice improved, I developed a severe dry cough for over half a month, which persists.
I feel like I have phlegm, but I can't cough it up, or it is clear and slightly thick.
2.
If I talk a little too much or too quickly, I start to feel short of breath and cough continuously.
3.
A month after the accident, I began experiencing frequent chest tightness, with a heart rate between 90-100 beats per minute.
Occasionally, my heart would suddenly race, causing mild pain.
I originally had slightly low blood pressure, but that seems to have resolved.
Traditional Chinese medicine practitioners believe there may be slight compression at the C2-C3 levels.

I would like to ask if this could be related to the sympathetic nervous system, and which specialty I should consult for further examination.
Should I bring my X-ray films?

yu, 20~29 year old female. Ask Date: 2004/12/27

Dr. Chen Fuquan reply Internal Medicine

Hello Miss,
1.
After your car accident, the neurosurgery department conducted X-rays and MRI examinations, diagnosing you with C-5 and C-6 subluxation.
You are currently wearing a cervical collar for observation.
During this time, please be cautious with your neck and avoid any strain or twisting (as this could lead to quadriplegia).
2.
Some of your symptoms post-accident may be related to a cold and emotional stress (sympathetic nervous system hyperactivity, increased heart rate, and elevated blood pressure).
Therefore, please take care to protect your neck.
You are still young, and you should see improvement soon, so try not to worry excessively.
3.
Generally, the sympathetic nervous system originates from the thoracic and lumbar spinal nerves, not from the cervical region.
4.
I recommend that you visit our hospital's neurosurgery outpatient clinic for follow-up (please bring all your X-rays with you).
Thank you!
Chen Fu-Chuan

Reply Date: 2004/12/27

More Info

After a cervical spine injury, particularly following a car accident, it is not uncommon to experience a range of symptoms, including chest tightness, cough, and other respiratory issues. Your situation, involving a diagnosis of cervical spine dislocation at the C5-C6 levels, along with the symptoms you've described, warrants a comprehensive understanding of the potential connections between these symptoms and your injury.

Firstly, the cervical spine is closely linked to the nervous system, particularly the sympathetic nervous system, which is responsible for the body's 'fight or flight' responses. When the cervical spine is injured, it can lead to irritation or compression of the nerves that emerge from the spinal cord. This can result in various symptoms, including pain, muscle tightness, and even autonomic symptoms such as changes in heart rate and respiratory function.

1. Chest Tightness and Heart Rate Changes: The tightness in your chest and the increased heart rate (tachycardia) you are experiencing could be related to the sympathetic nervous system being activated due to pain or stress from your injury. The body often responds to pain with increased sympathetic activity, which can lead to feelings of anxiety, chest tightness, and elevated heart rates. It is essential to monitor these symptoms, especially if they are accompanied by any signs of distress or if they worsen.

2. Coughing and Throat Issues: The sudden loss of voice and subsequent cough could be attributed to several factors. The irritation of the vocal cords and throat due to inflammation or muscle tension can lead to voice changes and a persistent cough. Additionally, the sensation of having phlegm that is difficult to expel may indicate post-nasal drip or bronchial irritation, which can occur after trauma or due to stress responses in the body. The fact that you have experienced these symptoms following your accident suggests that they could be related to the overall trauma and inflammation in your body.

3. Anxiety and Stress Response: It is also important to consider the psychological impact of your injury. Anxiety can exacerbate physical symptoms, including chest tightness and respiratory issues. If you find that your symptoms worsen with stress or anxiety, it may be beneficial to address these aspects through relaxation techniques, counseling, or other supportive measures.

4. Recommended Actions: Given the complexity of your symptoms, it is advisable to follow up with a healthcare provider who specializes in neurology or rehabilitation medicine. They can perform a thorough evaluation and may recommend imaging studies, such as MRI or CT scans, to assess any ongoing issues with your cervical spine. It is also essential to bring any previous imaging results, including X-rays, to provide a complete picture of your condition.

5. Management Strategies: In the meantime, consider implementing some self-care strategies:
- Gentle Neck Exercises: Once cleared by your physician, gentle stretching and strengthening exercises for the neck may help alleviate muscle tension.

- Breathing Exercises: Practicing deep breathing can help manage feelings of tightness in the chest and improve overall relaxation.

- Hydration and Humidification: Staying well-hydrated and using a humidifier can help with throat irritation and coughing.

In conclusion, your symptoms of chest tightness, cough, and changes in heart rate may indeed be interconnected with your cervical spine injury and the body's response to trauma. It is crucial to seek further evaluation and management from a qualified healthcare professional to address these concerns comprehensively.

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