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M - Cardiovascular Integrity

FIGURE 1.0. POTENTIAL MECHANISMS CONTRIBUTING TO THE DEVELOPMENT OF CVD AMONG INDIVIDUALS WITH SCI. Figure 1.0 Potential Mechanisms Responsible for the Development of CVD, among Individuals with SCI. Autonomic Dysreflexia: Can be Dangerous if Not Recognized and Treated Autonomic Dysreflexia (AD) is a sudden 20-40 mmHg increase in blood pressure above baseline, in response to a noxious or non-noxious stimulus, below the level of the SCI (Table 1.0). AD is typically associated with a specific constellation of signs and symptoms, including headache, sweating, goose bumps, facial flushing above the level of the injury, and pallor below the level, a runny nose, and irritability or a sense of doom. Even small changes in blood pressure, combined with these symptoms, require urgent attention. Severe, prolonged AD is a life-threatening emergency and can result in stroke, angina, heart attack, seizure, retinal hemorrhage, arrhythmia or death, if not recognized. AD is easily managed, if recognized early and treated appropriately.  An approach to the treatment of AD is outlined later in this chapter. Major signs and symptoms of AD that individuals often present, within emergency departments, are reported in Figure 2.0. Table 1.0 Causes of Autonomic Dysreflexia COMMON CAUSES OF AD UNCOMMON CAUSES OF AD Body System Causes Body System Causes Bladder Distension, Urinary Tract Infection (UTI), Detrusor Sphincter Dyssynergia Urinary Tract and Genitals Bladder or Kidney Stones, Epididymitis, Scrotal Compression, Coitus, Menses, Pregnancy Bowel Distension, Hemorrhoids Skin Pressure Sores, Burns, Blisters, Bites, Pressure from Tight, Hard or Sharp Objects Skin Constrictive Clothing/ Device, Pressure Sore, Ingrown Toenail Musculoskeletal Heterotopic Bone, Fractures, Trauma OTHER CAUSES Tests/ Diagnostics Surgery/ Pregnancy (Iatrogenic) Cystoscopy/Urodynamic Colonoscopy/Suctioning Vibrostimulation for Sperm Retrieval Uterine Contraction /Delivery of Children 128 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


M - Cardiovascular Integrity
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