RSD/CRPS Has A Negative Effect On Cardiac Function

RSD/CRPS is a very painful condition and initially patients may not full understand the long term implications of their condition of their cardiac function.

RSD/CRPS causes three independent negative influences on cardiac function.

1. The sympathetic system is responsible for three main functions, i.e., temperature regulation, vital signs, and regulation of the immune system. The vital signs in the form of heart beat, blood pressure and respiration are up regulated and accelerated by stimulation of the sympathetic system. RSD/CRPS is not a simple hyperactivity only causing stimulation of the sympathetic system, but it is the result of dysfunction of the sympathetic system. This dysfunction shows an instability of the sympathetic system at times causing fluctuation of blood pressure and at other times bringing on attacks of rapid heart beat.

2. The second reason RSD/CRPS affects cardiac function is due to the anatomical innervation of the heart muscles. Of all the visceral organs, the heart has the richest innervation of the sympathetic system, which is in the form of the cardiac plexus, a rich plexus of nerves surrounding the heart. In any stressful condition, the natural response is rapid heart beat accompanied by an increase in blood pressure. The RSD/CRPS being a distressful type of dysfunction of the sympathetic system, results in repetitive pathological and exaggerated response of the sympathetic system to stress, chest pain, palpation, with frequent bouts of high blood pressure.

3. One of the main principles with the development of RSD/CRPS is inflammation and RSD/CRPS is a condition with four major features:

  • First, the allodynia and hyperpathia typical with pains seen with sympathetic dysfunction.
  • Second, motor response to such pain in the form of vasoconstriction, muscle spasm and tremor.
  • Thirdly, inflammation in the form of skin rash, swelling of soft tissues of the extremities, and increased circulation in the visceral structures resulting in osteoporosis, pelvic inflammation, and attacks of vascular headaches.
  • The same inflammation and increased visceral circulation causes distress on the heart. Obviously if the patient has already had pre-existing cardiac disease, the distressful disease of RSD/CRPS is going to cause further stress on the heart on the basis of the above mentioned three principles.

Atypical chest pain is a common complaint among Complex Regional Pain Syndrome (RSD/CRPS) patients with brachial plexus involvement. Anatomically, the intercostobrachial nerve (ICBN) is connected to the brachial plexus and innervates the axilla, medial arm and anterior chest wall. By connecting to the brachial plexus, the ICBN could become sensitized by RSD/CRPS spread and become a source of atypical chest pain.
A history of chest pain was reported by a majority (94%) of RSD/CRPS patients who reported lifting their arm as a major initiating factor for chest pain, indicating increased chest wall sensitivity. The results of this study support the idea that chest pain is greater in RSD/CRPS patients than normal and the ICBN could be the source of this sensitization by spreading from the brachial plexus.

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