Spinal Dural Arteriovenous Fistula masquerading as Non-ST-Elevation Myocardial Infarction-Lesson learnt

Spinal Dural Arteriovenous Fistula masquerading as Non-ST-Elevation Myocardial Infarction

Résumé

Background: Spinal dural arteriovenous fistulas are rare vascular anomalies commonly affecting men aged 50-70 yrs. They involve abnormal connections between dural arteries and veins, causing venous hypertension and spinal cord dysfunction, often presenting with nonspecific symptoms like myelopathy and motor deficits. Treatment options include endovascular embolization and surgical ligation, aiming to obliterate the fistula while preserving spinal cord function.

Case Description: A 60-year-old male with no significant medical history presented with chest pain.  He was initially diagnosed as NSTEMI (Non-ST-Elevation Myocardial Infarction), he progressively worsened to paraplegia in 8 hrs time. Imaging revealed a spinal dural arteriovenous fistula (AVF) at the D6 level. The patient underwent successful surgical intervention with partial recovery of motor function and sensation in the lower limbs. He was discharged with follow-up recommendations for physiotherapy and urinary catheter care.

Conclusion: This case underscores the importance of considering spinal AVF in patients having chest pain with  neurological symptoms.